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Intraductal papillary neoplasm originating from an anomalous bile duct

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Abstract

An 82-year-old woman who had been suffering from repeated obstructive jaundice for 7 years was referred to our hospital. Although endoscopic aspiration of the mucin in the common bile duct had been temporally effective, origin of the mucin production had not been detectable. The patient thus had been forced to be on long-term follow-up without curative resection. Endoscopic retrograde cholangioscopy on admission revealed massive mucin in the common bile duct. In addition, an anomalous bile duct located proximal to the gallbladder was identified. Since the lumen of the anomalous duct was irregular and the rest of biliary tree was completely free of suspicious lesions, the anomalous duct was judged to be the primary site. Surgical resection of the segment 4 and 5 of the liver combined with the extrahepatic biliary tract was performed. Pathological diagnosis was compatible to intraductal papillary neoplasm with high-grade intraepithelial dysplasia of the anomalous bile duct. The patient has been free from the disease for 6.5 years after resection. This is the first case of intraductal papillary neoplasm derived from an anomalous bile duct, which was resected after long-term conservative treatment. The present case suggested the slow growing character of natural history of the neoplasm.

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Abbreviations

IPNB:

Intraductal papillary neoplasm of the biliary duct

WHO:

World Health Organization

IPMN-P:

Intraductal papillary neoplasm of the pancreas

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Acknowledgements

The authors thank Rumi Hino, Tetsuo Ushiku, and Masashi Fukayama at Department of Pathology, Graduate School of Medicine, The University of Tokyo, for their kind advice for histological diagnosis of the present case.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Harufumi Maki, Taku Aoki, Takeaki Ishizawa, Yoshifumi Beck, Kiyoshi Hasegawa, Yoshihiro Sakamoto & Norihiro Kokudo

  2. Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Mariko Tanaka & Takashi Sakatani

Authors
  1. Harufumi Maki
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  2. Taku Aoki
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  3. Takeaki Ishizawa
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  4. Mariko Tanaka
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  5. Takashi Sakatani
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  6. Yoshifumi Beck
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  7. Kiyoshi Hasegawa
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  8. Yoshihiro Sakamoto
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  9. Norihiro Kokudo
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Correspondence to Norihiro Kokudo.

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All the authors declare that they have no conflict of interests.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Written informed consent was obtained from the patient for publication of this Case report and any accompanying images.

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Maki, H., Aoki, T., Ishizawa, T. et al. Intraductal papillary neoplasm originating from an anomalous bile duct. Clin J Gastroenterol 10, 174–178 (2017). https://doi.org/10.1007/s12328-017-0721-8

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  • DOI: https://doi.org/10.1007/s12328-017-0721-8

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