A comparison of hepatic mucinous cystic neoplasms with biliary intraductal papillary neoplasms.
OBJECTIVE
There is controversy regarding the term biliary intraductal papillary neoplasms (IPN-B) and their pathology, which frequently are confused with hepatic mucinous cystic neoplasms (MCN). We aimed to summarize the clinicopathologic features of IPN-B and differentiate them from MCN.


METHODS
From January 1998 to December 2007, there were 19 patients with intrahepatic IPN-B and 13 patients with MCN who underwent surgical treatment at Zhongshan Hospital. Multiple demographic and clinicopathologic parameters were reviewed retrospectively and compared between the groups.


RESULTS
The mean ages of patients with IPN-B and MCN were 59.5 +/- 11.1 and 44.4 +/- 9.7 years, respectively (P = .0004); the male:female ratios also differed (11:8 vs 2:11; P = .028). Tumors were significantly smaller (6.0 vs 11.2 cm; P = .006) in patients with IPN-B than in those with MCN. More patients with IPN-B also had hepatolithiasis (47.4% vs 0%, P = .004); cholangiectasis and communication between the cyst and main bile duct were more frequent in patients with IPN-B than in those with MCN (P < .001). The IPN-B consisted of 4 subtypes--the gastric subtype was the least invasive. Malignant lesions were more common in patients with IPN-B than in those with MCN (78.9% vs 38.5%; P = .03). The overall 5-year survival rates of patients with IPN-B and MCN were 82% and 100%, respectively.


CONCLUSIONS
Intrahepatic IPN-B represents a distinct clinicopathologic entity that differs clinically, histologically, and radiologically from MCN. Curative resection has a favorable prognosis for patients with IPN-B, but further studies of its subtype are required.
Li
Tao
T
Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China.
Ji
Yuan
Y
Zhi
Xu-Ting
XT
Wang
Lu
L
Yang
Xin-Rong
XR
Shi
Guo-Ming
GM
Zhang
Wei
W
Tang
Zhao-You
ZY
D000328:Adult; D000367:Age Factors; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D012189:Retrospective Studies; D012737:Sex Factors