Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct

Jung, Geunhwa; Park, Kwang-Min; Lee, Seung Soo; Yu, Eunsil; Hong, Seung‐Mo; Kim, Jihun

doi:10.1016/j.jhep.2012.05.008

Cited by 101 publications

(86 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[11][12][13][14][15][16] In contrast to the more common pancreatic intraductal papillary mucinous neoplasms, intraductal papillary neoplasms of the bile duct have not been well characterized so far, either from the clinical or from the molecular point of view. Most studies of intraductal papillary neoplasms of the bile duct are based on small number of patients, 2,[17][18][19][20][21] and the three largest studies (55-97 patients) [22][23][24] exclusively enrolled Asiatic patients, a considerable proportion of them with hepatolithiasis or Clonorchiasis infection. 24 Therefore, little is known about the prognostic relevance of the histological subtypes 17,23 and the oncogenic pathways underlying the development of these tumors, especially of those occurring sporadically in Western countries.…”

mentioning

confidence: 99%

“…Most studies of intraductal papillary neoplasms of the bile duct are based on small number of patients, 2,[17][18][19][20][21] and the three largest studies (55-97 patients) [22][23][24] exclusively enrolled Asiatic patients, a considerable proportion of them with hepatolithiasis or Clonorchiasis infection. 24 Therefore, little is known about the prognostic relevance of the histological subtypes 17,23 and the oncogenic pathways underlying the development of these tumors, especially of those occurring sporadically in Western countries. [25][26][27][28][29] In this study, we analyzed a large series of intraductal papillary neoplasms of the bile duct from the patients of European origin, with focus on molecular genetic changes in relation to morphology, distribution of different subtypes and their prognostic relevance.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Intraductal papillary neoplasms of the bile duct: stepwise progression to carcinoma involves common molecular pathways

Schlitter

Born

Bettstetter³

et al. 2014

Modern Pathology

132

131

View full text Add to dashboard Cite

Intraductal papillary neoplasms of the bile duct are still poorly characterized regarding (1) their molecular alterations during the development to invasive carcinomas, (2) their subtype stratification and (3) their biological behavior. We performed a multicenter study that analyzed these issues in a large European cohort. Intraductal papillary neoplasms of the bile duct from 45 patients were graded and subtyped using mucin markers and CDX2. In addition, tumors were analyzed for common oncogenic pathways, and the findings were correlated with subtype and grade. Data were compared with those from 22 extra-and intrahepatic cholangiocarcinomas. Intraductal papillary neoplasms showed a development from preinvasive low-to highgrade intraepithelial neoplasia to invasive carcinoma. Molecular and immunohistochemical analysis revealed mutated KRAS, overexpression of TP53 and loss of p16 in low-grade intraepithelial neoplasia, whereas loss of SMAD4 was found in late phases of tumor development. Alterations of HER2, EGFR, b-catenin and GNAS were rare events. Among the subtypes, pancreato-biliary (36%) and intestinal (29%) were the most common, followed by gastric (18%) and oncocytic (13%) subtypes. Patients with intraductal papillary neoplasm of the bile duct showed a slightly better overall survival than patients with cholangiocarcinoma (hazard ratio (cholangiocarcinoma versus intraductal papillary neoplasm of the bile duct): 1.40; 95% confidence interval: 0.46-4.30; P ¼ 0.552). The development of biliary intraductal papillary neoplasms of the bile duct follows an adenomacarcinoma sequence that correlates with the stepwise activation of common oncogenic pathways. Further large trials are needed to investigate and verify the finding of a better prognosis of intraductal papillary neoplasms compared with conventional cholangiocarcinoma.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Intraductal papillary neoplasms of the bile duct: stepwise progression to carcinoma involves common molecular pathways

Schlitter

Born

Bettstetter³

et al. 2014

Modern Pathology

132

131

View full text Add to dashboard Cite

show abstract

“…La neoplasia papillare intraduttale mucinosa del pancreas è caratterizzata da una una chiara evidenza clinica o radiologica di cancerizzazione a patto di un'accurata rivalutazione intraoperatoria [23][24][25][26][27][28][29]. L'esame istologico estemporaneo di margini di resezione pancreatica è utile per minimizzare il rischio di escissioni incomplete [24].…”

Section: Discussioneunclassified

“…L'esame istologico estemporaneo di margini di resezione pancreatica è utile per minimizzare il rischio di escissioni incomplete [24]. L'ecografia intraoperatoria (IOUS) può essere di aiuto nella rivalutazione dell'estensione della neoplasia e dell'eventuale presenza di linfoadenopatie, oltre che nella definizione dei margini di resezione [25][26][27].…”

Section: Discussioneunclassified

Main-duct intraductal papillary mucinous neoplasm of the pancreas: a case report

Manetti

Faini

Bucciero

et al. 2012

CMI

View full text Add to dashboard Cite

INTRODUZIONELe neoplasie mucinose cistiche del pancreas possono essere classificate in due gruppi ben distinti: neoplasie papillari mucinose intraduttali (IPMN) e neoplasie mucinose cistiche (MCN) (Tabella I).Queste ultime sono maligne o potenzialmente tali anche se con una crescita molto lenta rispetto alle IPMN [2]. Spesso interessano donne di mezza età e la sintomatologia di esordio consiste principalmente in dolore addominale e presenza di una massa palpabile in epigastrio. Sono solitamente localizzate nella coda del pancreas e sono costituite da cisti mucinose uniloculari o multiloculari ben circoscritte con dimensioni medie di 7-10 cm [3,4] Caso clinico AbstractThree distinct entities among non-inflammatory cystic lesions of the pancreas have been defined: intraductal papillary mucinous neoplasm (IPMN), serous cystic neoplasm (SCN) and mucinous cystic neoplasm (MCN). IPMN is characterized by intraductal papillary growth and thick mucus secretion: its incidence has dramatically increased since its initial description. These lesions probably can progress towards invasive carcinoma. IPMNs are symptomatic in most cases: the typical presentation is a recurrent acute pancreatitis, without evident cause, of low or moderate severity. The diagnosis is usually based upon the imaging (CT/cholangio-MRI) demonstrating a pancreatic cystic mass, involving a dilated main duct, eventually associated to some filling defects, or a normal Wirsung duct communicating with the cyst lesion. Surgical treatment is generally indicated for main duct IPMN and branch duct IPMN with suspected malignancy (tumour size ≥ 30 mm, mural nodules, dilated main pancreatic duct, or positive cytology) or prominent symptoms. Herein we present a case of IPMN of the main duct which occurred with abdominal and back pain associated with weight loss. After the diagnosis, she successfully underwent surgery and is now in a follow-up program.

show abstract

“…The most common primary sites within the biliary tree are at the hilum and the left intrahepatic ductal system [1][2][3]. The presence of MUC1 and CEA positivity in the immunostain indicate a high likelihood of recurrence and poor prognosis [4][5][6]. Immunohistochemical examination of resection IPNB with invasion demonstrates overexpression of MUC 1 and CEA [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

A Rare Cause of Biliary Obstruction

Makipour¹

2014

J Liver

View full text Add to dashboard Cite

Objective: To discuss a rare cause of obstructive jaundice. Methods:A case report is presented with emphasis on diagnosis and management. Six month follow up is also presented. Results:A 42 year old African-American male presented with one week of painless jaundice. He underwent imaging via CT abdomen pancreatic protocol and MRCP demonstrating a massively dilated common bile duct of 12 cm and diffuse intrahepatic ductal dilation. He subsequently developed pruritus, RUQ abdominal pain, and cholangitis thus necessitating an endoscopic retrograde cholangiopancreatography (ERCP). ERCP was performed but not useful in delineating the biliary tree anatomy or relieving biliary obstruction. Later percutaneous transhepatic cholangiography (PTC) was performed to provide drainage and was also not useful in delineating his biliary tree anatomy. Shortly thereafter he underwent laparotomy, choledochal cyst and bile duct resection, Roux en Y pancreaticojejunostomy and hepaticojejunostomy. A review of the pathologic specimen indicates the presence of intrapapillary neoplasm of the bile duct (IPNB) which is a rare variant of a bile duct tumor. The specimen was positive for MUC1 and CEA which indicates a high possibility of recurrence. Conclusions:Invasive carcinoma has been found to be present in 70-80% of cases of resected IPNB. However, survival has been shown to be better in patients with IPNB compared to those with conventional bile duct tumors. Given the difficulty of preoperative diagnosis of these lesions and their high predisposition for invasion all IPNB should be surgically resected.

show abstract

Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct

Cited by 101 publications

References 23 publications

Intraductal papillary neoplasms of the bile duct: stepwise progression to carcinoma involves common molecular pathways

Intraductal papillary neoplasms of the bile duct: stepwise progression to carcinoma involves common molecular pathways

Main-duct intraductal papillary mucinous neoplasm of the pancreas: a case report

A Rare Cause of Biliary Obstruction

Contact Info

Product

Resources

About