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Case Reports
. 2023 Jul 3:13:1114514.
doi: 10.3389/fonc.2023.1114514. eCollection 2023.

Intraductal papillary mucinous neoplasm of the biliary tract in the caudate lobe of the liver: a case report and literature review

Xunhao Zhu  1 , Qingqiang Ni  1 , Qianchang Wang  1 , Chaoqun Ma  1 , Faji Yang  1 , Hengjun Gao  1 , Huaqiang Zhu  1 , Xu Zhou  1 , Hong Chang  1 , Jun Lu  1 , Fangfeng Liu  1
Affiliations
Case Reports

Intraductal papillary mucinous neoplasm of the biliary tract in the caudate lobe of the liver: a case report and literature review

Xunhao Zhu et al. Front Oncol. .

Abstract

An intraductal papillary mucinous neoplasm of the biliary tract (BT-IPMN) in the caudate lobe of the liver is a rare tumor originating from the bile duct. Approximately 40% of the intraductal papillary neoplasms of the biliary tract (IPNB) secrete mucus and can grow in the intrahepatic or extrahepatic bile ducts. A 65-year-old woman presented with recurrent episodes of right upper pain. She developed her first episode 8 years ago, which resolved spontaneously. The frequency of symptoms has increased in the last 2 years. She underwent laparoscopic hepatectomy and choledochal exploration and was pathologically diagnosed with a rare BT-IPMN of the caudate lobe after admission. Here, we review studies on IPNB cases and systematically describe the pathological type, diagnosis, and treatment of IPNB to provide a valuable reference for hepatobiliary surgeons in the diagnosis and treatment of this disease.

Keywords: bile duct; biliary tract surgery; diagnosis; intraductal papillary mucinous neoplasm; pathology; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Abdominal computer tomography (CT) of the patient. Left arrow shows the dilated bile duct with a diameter of 2.1 cm. The right arrow indicates the tumor with a diameter of 4 cm.
Figure 2
Figure 2
Abdominal magnetic resonance imaging (MRI) of the patient. Arrows show the dilated left and right bile ducts.
Figure 3
Figure 3
Abdominal magnetic resonance cholangiopancreatography (MRCP) of the patient. Arrow shows the blocked common bile duct.
Figure 4
Figure 4
Pathological image 1 (100× magnification) (A) Cystic tumor: the inner wall of the cyst is lined with mucoepithelial cells showing papillary arrangement with mucus in the cyst cavity. (B) Papillary structure in the cyst: cytoplasmic vacuoles and papillary structure with vascular axes could be seen. (C) Immunohistochemistry: Ki67 proliferation index was 40% positive.
Figure 5
Figure 5
Pathological image 2 (400× magnification) (A) Tumor cytoplasm was stained red, which showed nuclear deviation, multisided arrangement, and mild cellular hyperplasia. (B) Papillary structure of the tumor. (C) vascular axes could be seen in the cytoplasm, which is the true papillary structure.
Figure 6
Figure 6
IPNB grading.
See this image and copyright information in PMC

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