Distinction between intraductal papillary neoplasms and hepatic mucinous cystic neoplasms

Abstract

Objective To compare the clinicopathologic features of biliary intraductal papillary neoplasm (bIPN) and mucinous cystic neoplasms (MCN).Methods The clinical,pathological and prognostic data of 22 patients with bIPN and 14 patients with MCN who underwent surgical treatment from January 1998 to July 2013 were retrospectively analyzed and compared.Results Patients with bIPN were significantly older than patients with MCN (59.7 ± 10.8 vs 44.9 ±9.6,P ＜0.001).Tumors of the bIPN patients were much smaller than those of the MCN patients [(5.5 ± 3.3) cm vs (11.7 ± 5.4) cm,P =0.009].The main symptoms of both bIPN and MCN patients were abdominal pain (31.8％ vs 35.7％,P =0.809),but bIPN patients were more commonly associated with hepatolithiasis (40.9％ vs 0,P =0.006).The location of the mass differed,with bIPN usually occurring in the left lobe,whereas MCN in the right lobe (P =0.028).Luminal communication between cystic tumors and bile ducts was detected in all surgically resected bIPN,which was significantly different from the MCN (100％ vs 0％ ; P ＜ 0.001).Malignant lesions were more common in bIPN patients than in MCN patients (81.8％ vs 42.9％ ; P =0.029).The overall 5-year survival rates of patients with bIPN and MCN were 85.3％ and 100％ respectively (P =0.097).Conclusions bIPN represents a distinct clinicopathologic entity that differs clinically and histologically from MCN.Curative resection has a favorable prognosis for patients with bIPN or MCN. Key words: Liver; Bile duct; Papillary neoplasms ; Cystic neoplasms; Diagnosis differential