Abstract
BackgroundAlthough intraductal papillary mucinous neoplasm (IPMN) of the pancreas is acceptable as a distinct disease entity, the concept of mucin-secreting biliary tumors has not been fully established.Case presentationWe describe herein a case of mucin secreting biliary neoplasm. Imaging revealed a cystic lesion 2 cm in diameter at the left lateral segment of the liver. Duodenal endoscopy revealed mucin secretion through an enlarged papilla of Vater. On the cholangiogram, the cystic lesion communicated with bile duct, and large filling defects caused by mucin were observed in the dilated common bile duct. This lesion was diagnosed as a mucin-secreting bile duct tumor. Left and caudate lobectomy of the liver with extrahepatic bile duct resection and reconstruction was performed according to the possibility of the tumor's malignant behavior. Histological examination of the specimen revealed biliary cystic wall was covered by micropapillary neoplastic epithelium with mucin secretion lacking stromal invasion nor ovarian-like stroma. The patient has remained well with no evidence of recurrence for 38 months since her operation.ConclusionIt is only recently that the term "intraductal papillary mucinous neoplasm (IPMN)," which is accepted as a distinct disease entity of the pancreas, has begun to be used for mucin-secreting bile duct tumor. This case also seemed to be intraductal papillary neoplasm with prominent cystic dilatation of the bile duct.
Highlights
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is acceptable as a distinct disease entity, the concept of mucin-secreting biliary tumors has not been fully established.Case presentation: We describe a case of mucin secreting biliary neoplasm
Based on the imaging for intraductal papillary tumors of the bile duct, mucin component was detected as filling defect at cholangiography and the papillary tumor was detected as polypoid mass in the dilated biliary tree as well as intraductal papillary mucinous neoplasm (IPMN) of pancreas [1,12]
It is only recently that the term "intraductal papillary mucinous neoplasm (IPMN)," which is accepted as a distinct disease entity of the pancreas, has begun to be used as "intraductal papillary neoplasm of the bile duct (IPNB)" for mucin-secreting bile duct tumor
Summary
It is only recently that the term "intraductal papillary mucinous neoplasm (IPMN)," which is accepted as a distinct disease entity of the pancreas, has begun to be used as "intraductal papillary neoplasm of the bile duct (IPNB)" for mucin-secreting bile duct tumor. Endoscopic ultrasonography showed no mass protruding into the lumen in the bile duct and the cystic lesion at the left lateral segment of the liver (B). EmFniugdcuoinrseco4pic retrograde cholangiography (A) shows a dilated common bile duct with defined filling defects corresponding to Endoscopic retrograde cholangiography (A) shows a dilated common bile duct with defined filling defects corresponding to mucin. Percutaneous transhepatic cholangiography (B) shows mucin in the common bile duct and a communication between the cystic lesion and bile duct. Arrows head indicate mucin in the common bile duct. IPN of the bile duct are reported, consensus could be achieved regarding the optimal and least invasive preoperative evaluation and treatment plans
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