Post-cholecystectomy amputation neuroma mimicking common bile duct carcinoma

Amputation neuromas, also known as traumatic neu- romas represent reactive proliferation of nerve fibers that are encased in Schwann cells (1). Amputation neuroma of the common bile duct can occur after cholecystectomy because the common bile duct is surrounded by an abun- dant nerve supply (2). They always occur at the distal ends of the proximal segments of severed nerves and are characterized by a neural enmeshment in an overgrowth of the Schwannian sheath cells (3). Amputation neuro- mas are usually found in amputated extremities but they have been reported following radical mastectomy, mas- toidectomy, thyroglossal cystectomy and even circumci- sion (4). Amputation neuromas of the biliary tract are usually asymptomatic, rarely they present with intermit- tent symptomatic right upper quadrant pain and jaundice. In most cases, the leading differential diagnosis is cholangiocarcinoma due to the similarity of presenta- tion (2,5).