Abstract
Invasive micropapillary carcinoma (IMPC) is defined as a carcinoma composed of small clusters of tumor cells lying within clear spaces which simulate lymphovascular channels. This histologic pattern has been described in various organs, including the breast, lung, urinary bladder, ovary, stomach, pancreas, and major salivary glands. Although rarely observed as a pure histologic component, IMPC is usually mixed with conventional carcinoma, and is therefore often referred to as carcinoma with a micropapillary component. IMPCs are invariably associated with a high degree of aggressiveness, extensive lymphovascular invasion, extensive lymph node metastases, and poor prognosis. Here a case of bile duct adenocarcinoma with minor micropapillary component is described.
Highlights
Invasive micropapillary carcinoma (IMPC) is defined as a carcinoma composed of small clusters of tumor cells lying within clear spaces, and was proposed as a histological variant of invasive breast carcinoma with poor clinical prognosis [1]
The patient had undergone pancreaticoduodenectomy for her tumor surrounding the inferior common bile duct, measuring 11 mm on cut surface (Fig. 1). It was composed of conventional adenocarcinoma with severe neutrophilic infiltration (Fig. 2A), and a small focus (2 mm in size) of micropapillary carcinoma was found in Oddi's sphincter (Fig. 2B)
Compared with conventional carcinomas of similar size, hypothetically this reverse polarization in IMPC facilitates the secretion by tumor cells of molecules, such as metalloproteinases, known to be responsible for stromal and vascular invasion, permitting easier dissemination and a higher tendency for lymph node metastases [1]
Summary
Invasive micropapillary carcinoma (IMPC) is defined as a carcinoma composed of small clusters of tumor cells lying within clear spaces, and was proposed as a histological variant of invasive breast carcinoma with poor clinical prognosis [1]. The patient had undergone pancreaticoduodenectomy for her tumor surrounding the inferior common bile duct, measuring 11 mm on cut surface (Fig. 1) It was composed of conventional adenocarcinoma with severe neutrophilic infiltration (Fig. 2A), and a small focus (2 mm in size) of micropapillary carcinoma was found in Oddi's sphincter (Fig. 2B). The patient is alive and free of the recurrent disease at the latest followup (after 1 year since the operation)
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