Intracholecystic Papillary Neoplasm: A New Entity

Abstract

Introduction Gallbladder neoplasms are a rare pathology with an incidence of 1–2 cases per 100,000 inhabitants. In the group of gallbladder neoplasms, adenocarcinoma of the gallbladder is the most common (95% of the total). Intracholecystic papillary neoplasm (ICPN) is a new entity considered to be a premalignant lesion of the gallbladder. In the few published series, it is found in 0.5–4% of cholecystectomies and up to 6% of intracholecystic adenocarcinomas are located on an ICPN. We present the case of a patient with an ICPN with a brief review of its epidemiology and characteristics. Clinical case A 65-year-old woman with a history of supraglottic squamous cell carcinoma, squamous cell carcinoma of the lung and metastasis in the tail of the pancreas of squamous cell carcinoma who, after 2 years of stable disease with Pembrolizumab and radiotherapy, presented with an atypical thickening of the gallbladder on ultrasound of the abdomen. It was decided to perform a programmed cholecystectomy, with discharge 24 hours after the intervention. Subsequent anatomopathological analysis revealed a 0.8 cm nodular thickening with histological findings of non-infiltrating ICPN in the context of chronic inflammatory changes of the gallbladder. Discussion ICPN usually presents as an incidental finding, although 50% of cases present with right hypochondrium pain and fever. It is a poorly described premalignant lesion that requires further studies in order to define its tumorogenesis, clinicopathologic characteristics and actual prevalence.