An intraductal papillary neoplasm of the bile duct mimicking a hemorrhagic hepatic cyst: a case report

World Journal of Surgical Oncology

Akinobu Taketomi¹  Tomoko Mitsuhashi²  Hirofumi Kamachi¹  Yosuke Tsuruga¹  Kenji Wakayama¹  Kazuaki Nakanishi¹  Hideki Yokoo¹  Toshiya Kamiyama¹  Tatsuhiko Kakisaka¹ 

[1] Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan;Department of Surgical Pathology, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan

关键词: Oncocytic;    Intraductal papillary neoplasm of the bile duct;    Hemorrhagic hepatic cyst;   

Others  :  824662
DOI  :  10.1186/1477-7819-11-111

 received in 2012-12-11, accepted in 2013-05-12,  发布年份 2013

【 摘 要 】

An intraductal papillary neoplasm of the bile duct is a biliary, epithelium-lined, cystic lesion that exhibits papillary proliferation and rarely causes large hemorrhagic cystic lesions. Here, we report a case of an intraductal papillary neoplasm of the bile duct mimicking a hemorrhagic hepatic cyst in a middle-aged man with large hemorrhagic hepatic cysts who experienced abdominal pain and repeated episodes of intracystic bleeding. Following portal vein embolization, extended right hepatic lobectomy was performed, and intraoperative cholangiography revealed communication between the intracystic space and the hepatic duct. Although histological studies revealed that the large hemorrhagic lesion was not lined with epithelium, the surrounding multilocular lesions contained biliary-derived epithelial cells that presented as papillary growths without ovarian-like stroma. A diagnosis of oncocytic-type intraductal papillary neoplasm of the bile duct was made, and we hypothesized that intracystic bleeding with denudation of the lining epithelial cells might occur as the cystically dilated bile duct increased in size. Differential diagnosis between a hemorrhagic cyst and a cyst-forming intraductal papillary neoplasm of the bile duct with bleeding is difficult. However, an intraductal papillary neoplasm of the bile duct could manifest as multilocular hemorrhagic lesions; therefore, complete resection should be performed for a better prognosis.

【 授权许可】

   
2013 Kakisaka et al.; licensee BioMed Central Ltd.

【 图 表 】

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