Intrahepatic intraductal papillary cystic neoplasm of the bile duct: A case report. (March 2021)

• Record Type: Journal Article
• Authors: Baltagiannis, Evangelos G.; Kalyvioti, Christina; Glantzouni, Anastasia; Batistatou, Anna; Tzimas, Petros; Glantzounis, Georgios K.
• Is Part Of: Annals of medicine and surgery. Volume 63(2021)
• Publication Date: 2021-03
• Subjects: Intraductal papillary neoplasm of the bile duct -- Diagnosis -- Management -- Liver resection -- Cystic liver lesion -- Case report; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.02.013
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction and importance: Intraductal papillary neoplasm of the bile duct (IPNB) is a tumour with a very low incidence in the Western world, characterised by a high risk of malignant transformation and unknown prognosis. It is a new entity which was adopted by the WHO in 2010 as a precursor lesion of cholangiocarcinoma. Intrahepatic bile duct is the most common site of origin for IPNB. Case presentation: Hereby, we present a case of an asymptomatic 63- year-old man, referred to our department after routine ultrasonography showing a multifocal cystic lesion on the left hepatic lobe. Further screening modalities (CT, MRI abdo) confirmed a complex cystic liver lesion with atypical features. The patient underwent left hepatectomy. Histopathology showed a cystic type intrahepatic IPNB, which was completely resected (R0). The follow up in 2 yrs post-operation showed no signs of recurrence. Clinical discussion: The diagnosis and management of IPNB remain challenging. A multimodality imaging approach is essential in order to diagnose IPNB, assess tumour location and extent and plan the optimal treatment strategy. Conclusion: Complete surgical resection (R0) with close postoperative follow-up offers long-term survival. Highlights: Intraductal papillary neoplasm of the bile duct (IPNB) is a rare bile duct epithelial tumour with very low incidence in the West and constitutes a precursor to the development of cholangiocarcinoma. The diagnosis and management of IPNB remains challenging. A multimodality imaging approach is essential in order to diagnose IPNB, assess tumor location and extent and plan the optimal treatment strategy. Complete surgical resection (R0) with close postoperative follow-up offers long-term survival.