Metachronous intracystic and intraductal papillary neoplasms of the biliary tree

Abstract

A 77-year-old woman complained of epigastralgia, and a tumor (5 cm in diameter) of the gallbladder neck was detected by image analysis. Following cholecystectomy, the tumor was pathologically diagnosed as intraductal papillary neoplasm (IPN), gastric type, with associated invasive carcinoma. About 10 mo later, intraluminal multiple masses (3 foci, up to 1.8 cm) were noted in the extrahepatic bile duct, and the resected specimen showed that all tumors had similar gross and microscopic features as seen in gallbladder IPN without invasion, and they were synchronous multiple lesions. This case showed a papillary tumor of the gallbladder of gastric phenotype, and confirmed that the gallbladder is a target of IPN in addition to the bile ducts.

The Relationship Between Intracholecystic Papillary-Tubular Neoplasms and Invasive Carcinoma of the Gallbladder

“…In the literature, although the adenomas are usually considered as invariably benign (especially if they are <1 cm), intracholecystic papillary neoplasms are usually reported to be associated with invasive tumors. [2][3][4][5][6] In the pancreas and biliary tract, the clinicopathological features and biological behavior of the tumors with intraductal papillary or tubulopapillary growth patterns are clearly known. 1,7,8 However, there are few studies about similar lesions in the GB, for which some authors use the term intracholecystic papillary-tubular neoplasm (ICPN).…”

A Rare Cause of Biliary Obstruction

“…IPNB is a very rare variant of a bile duct tumor and difficult to manage [1][2][3]. All cases necessitate surgical resection [7].…”

“…The primary site within the biliary tree does not affect prognosis or course of the disease [1][2][3]. 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].…”

“…Typical bile duct carcinoma is characterized initially by flat dysplasia while IPNB is characterized by an epiphytic proliferation of biliary epithelium on fibro vascular stalks [1]. IPNB is also associated with mucinhyper secretion and cystic dilation of the bile ducts [1][2][3]. The primary site within the biliary tree does not affect prognosis or course of the disease [1][2][3].…”

“…IPNB is also associated with mucinhyper secretion and cystic dilation of the bile ducts [1][2][3]. The primary site within the biliary tree does not affect prognosis or course of the disease [1][2][3]. The most common primary sites within the biliary tree are at the hilum and the left intrahepatic ductal system [1][2][3].…”