Clinicopathological features of "intraductal papillary neoplasm of the bile duct" and patient outcome after surgical resection.
OBJECTIVE
Intraductal papillary neoplasm of the bile duct (IPNB) represents a biliary papillary tumor mainly growing in the bile duct lumen resembling intraductal papillary mucin-producing neoplasm of the pancreas. However, its clinical spectrum and characteristics have not been fully evaluated.


METHODS
To define the clinicopathologic characteristics and prognosis of IPNB patients, 6 cases of IPNB who underwent surgical resection are presented.


RESULTS
Patients were 3 males and 3 females, aged between 47 and 79 years. Five patients had histories of hepatobiliary disease. Imagery showed cystic or diffuse dilatation of the bile ducts. Tumor markers were not valuable for diagnosis. All patients underwent hemihepatectomy with or without resection of the caudate lobe or extrahepatic bile duct. Examination showed polypoid tumors in 5 cases though 1 case had no evident tumor. Mucin was observed in 3 cases. Five cases were well-differentiated adenocarcinoma and 1 had poorly differentiated adenocarcinoma. Vascular invasion was rare and lymph node metastasis was not observed. In-situ spread of carcinoma was seen along biliary mucosa in 3 cases. Five cases survived without tumor relapse for long periods but 1 died of tumor recurrence at 31 months.


CONCLUSIONS
Complete resection of IPNB based on accurate preoperative assessment of tumor extension provides a good prognosis.
Nanashima
Atsushi
A
Division of Surgical Oncology Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
Kinoshita
Naoe
N
Nakanuma
Yasuni
Y
Zen
Yoh
Y
Sumida
Yorihisa
Y
Abo
Takafumi
T
Hidaka
Shigekazu
S
Takeshita
Hiroaki
H
Yasutake
Toru
T
Hayashi
Tomayoshi
T
Nagayasu
Takeshi
T
D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D002277:Carcinoma / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome