FDG PET/CT Findings in Malignant Intraductal Papillary Mucinous Neoplasm of the Bile Ducts

Abstract

A 58-year-old man with no significant symptoms was referred to the hospital due to the presence of an intrahepatic cystic tumor and a dilated intrahepatic bile duct. F-18 FDG PET/CT demonstrated intense FDG uptake in the marginal region of the cystic tumor. Subsequently, the patient underwent a right hemihepatectomy with extrahepatic bile duct resection. The histopathology revealed a malignant intraductal papillary mucinous neoplasm of the bile ducts with dysplasia. This report thus documents the FDG PET findings in malignant intraductal papillary mucinous neoplasm of the bile ducts, which showed an intense FDG uptake in the tumor.

Intraductal Papillary Neoplasia of the Bile Ducts (IPN-B): About a Case

“…HMCN is defined as a cyst-forming epithelial neoplasm with typical ovarian-type stroma but with no communication with the bile ducts. For IPNB patients without metastasis, surgical intervention is still the first choice of treatment including pancreaticoduodenectomy (31%), hemihepatectomy (28%), bile duct resection (18%), segmental liver resection (15%) and liver transplant (5%) [14,[15][16][17][18][19][20].…”

Intraductal Papillary Neoplasm of the Bile Duct Arising From a Background of Autoimmune Hepatitis: A Case Report

“…Imaging modalities for diagnosis of INPB in relation to pathological findings have made some degree of progress. IDUS is able to clearly demonstrate a malignant biliary tumor [15]. In addition, arterial blood flow or enhancement of the tumor wall/nodule tends to be demonstrated more commonly in biliary cystadenocarcinoma by CT or CT angiography than in cystadenoma [16].…”

Translational molecular imaging in exocrine pancreatic cancer

“…In the PET-PANC study (one of the larger studies of its kind, which prospectively evaluated the benefits of PET/CT imaging in 589 patients with PDAC across multiple hospitals in the UK), the use of 18 F-FDG PET/CT influenced management in 45% of patients and led to the avoidance of unnecessary surgery in 20% of patients [ 10 ]. Unfortunately, the occurrence of pancreatitis may complicate the interpretation of 18 F-FDG PET images as this inflammatory response, which coincidentally plays a significant role in PDAC tumorigenesis [ 11 ], can also lead to 18 F-FDG-avid foci. This effect is especially strong in the case of groove, autoimmune, and focal pancreatitis [ 12 ], and complicates the differentiation of PDAC from these more benign conditions.…”