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Amputation neuroma or traumatic neuroma is a tumor-like secondary hyperplasia that may develop after an accidental or surgical trauma. Amputation neuroma of the bile duct has occasionally been reported which occurred in the cystic duct stump late after the cholecystectomy. However, even if the amputation neuroma is suspected in a patient with late-onset jaundice after cholecystectomy, the differential diagnosis from a malignancy is difficult preoperatively. We experienced a case of the amputation neuroma of common bile duct (CBD) developed in a 70-year-old man who presented with a polypoid mass in CBD. He had undergone cholecystectomy 25 years ago and choledochojejunostomy 12 years ago, respectively. We have performed pylorus-preserving pancreatico-duodenectomy (PPPD) under the impression of CBD cancer. He had not been diagnosed of amputation neuroma until having undergone PPPD. We report a case of CBD neuroma mimicking CBD cancer, which was confirmed after PPPD.

Extrahepatic metastasis in patients with hepatocellular carcinoma (HCC) occurs frequently. The most common site of metastasis is the lung, followed by regional lymph nodes and bones. However, gastrointestinal metastasis of HCC is a rare condition and solitary polypoid metastatic lesion on stomach without any evidence of direct invasion from primary mass is very rare. These metastatic lesions are usually asymptomatic, and most are discovered at postmortem examination or are found incidentally during laparotomy. The choice of treatment for gastrointestinal metastatic lesion of HCC includes surgery, transarterial chemoembolization, and local injection but the treatment is often difficult and unsuccessful. We report a case of 69 years old man who presented disappearance of a polypoid metastatic lesion of HCC on the gastric fundus by transarterial chemoembolization.