Evangelos G Baltagiannis1, Christina Kalyvioti1, Anastasia Glantzouni2, Anna Batistatou3, Petros Tzimas4, Georgios K Glantzounis1. 1. HPB Unit, Department of Surgery, University Hospital of Ioannina and School of Medicine, University of Ioannina, Ioannina, Greece. 2. Department of Radiology, "G. Hatzikosta" General Hospital, Ioannina, Greece. 3. Department of Pathology, University Hospital of Ioannina and School of Medicine, University of Ioannina, Ioannina, Greece. 4. Department of Anesthesiology, University Hospital of Ioannina and School of Medicine, University of Ioannina, Ioannina, Greece.
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.
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.
Authors: Hyo Jung Park; So Yeon Kim; Hyoung Jung Kim; Seung Soo Lee; Gil Sun Hong; Jae Ho Byun; Seung-Mo Hong; Moon-Gyu Lee Journal: AJR Am J Roentgenol Date: 2018-04-09 Impact factor: 3.959
Authors: Xu-Feng Zhang; Malcolm H Squires; Fabio Bagante; Cecilia G Ethun; Ahmed Salem; Sharon M Weber; Thuy Tran; George Poultsides; Andre Y Son; Ioannis Hatzaras; Linda Jin; Ryan C Fields; Matthew Weiss; Charles Scoggins; Robert C G Martin; Chelsea A Isom; Kamron Idrees; Harveshp D Mogal; Perry Shen; Shishir K Maithel; Carl R Schmidt; Timothy M Pawlik Journal: Ann Surg Oncol Date: 2018-02-22 Impact factor: 5.344