Intracholecystic papillary neoplasm arising in the cystic duct and extending into common bile duct: a case report

Iseki, Masahiro; Mizuma, Masamichi; Aoki, Yasutaka; Aoki, Shuichi; Hata, Tatsuo; Takadate, Tatsuyuki; Kawaguchi, Koji; Masuda, Koichi; Ishida, Masaharu; Ohtsuka, Hideo; Nakagawa, Kazuhiko; Hayashi, Hiroki; Morikawa, Takanori; Kamei, Takashi; Kaneda, Kiyoshi; Kanno, Atsushi; Masamune, Atsushi; Omori, Yuko; Ono, Yoshio; Mizukami, Yusuke; Furukawa, Toru; Unno, Michiaki

doi:10.1007/s12328-020-01311-4

Cited by 8 publications

(11 citation statements)

References 12 publications

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“…Although ICPNs can be located in any part of the gallbladder, they frequently involve several parts, particularly the body and fundus [ 18 , 176 ]. Recent reports have identified ICPN arising in the cystic duct of the gallbladder [ 185 , 186 ]. Adsay et al reported ICPNs with the largest size of >10 mm [ 18 ], and this size criterion has been used as an inclusion criterion for ICPNs in many reports [ 178 , 182 , 183 ].…”

Section: Common Precursors Of the Biliary Tractmentioning

confidence: 99%

“…In contrast, for the solitary type, intraepithelial growth or intraglandular involvement is very limited or absent and corresponds to ICPN without surrounding dysplastic changes [ 175 , 185 ]. Certain ICPN cases arising in the cystic duct, show extensive intraepithelial spread in the extrahepatic bile duct (conglomerated type), whereas some show limited growth in the cystic duct (solitary type) [ 186 ].…”

Section: Common Precursors Of the Biliary Tractmentioning

confidence: 99%

“…In addition, cholesterol-containing foamy cells and squamoid morules were frequently observed in PGA, suggesting that PGA and gICPN can be differentiated histologically from each other [ 18 , 197 , 198 ]. PGA also presents with LGD, HGD, and an association with invasive carcinoma, such as in ICPN [ 1 , 185 ].…”

Section: Common Precursors Of the Biliary Tractmentioning

confidence: 99%

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Pathologies of Precursor Lesions of Biliary Tract Carcinoma

Nakanuma

Kakuda

Sugino

et al. 2022

Cancers

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Carcinomas and precursor lesions of the biliary tract belong to a spectrum of pancreatobiliary neoplasms that share common histology and cell lineages. Over the past two decades, preinvasive precursors to biliary tract carcinomas (BTCs) have been identified such as high-grade biliary intraepithelial neoplasm (high-grade BilIN), intraductal papillary neoplasm of bile duct (IPNB) and intracholecystic papillary neoplasm of the gallbladder (ICPN). While a majority of these precursors may arise from the biliary tract mucosa, some originate from the peribiliary glands and Rokitansky-Aschoff sinuses in the walls of the biliary tract. High-grade BilIN is a microscopically identifiable intraepithelial neoplasm of the biliary tract, whereas IPNB and ICPN are grossly visible intraductal or intraluminal preinvasive neoplasms in the bile duct and gallbladder, respectively. These neoplasms show characteristic histologic features according to four cell lineages and two-tiered grading, and show intraepithelial spreading to the surrounding mucosa and involve non-neoplastic glands in the walls of the biliary tract. These precursors are not infrequently associated with stromal invasion, and high-grade BilIN, in particular, are frequently identified in the surrounding mucosa of BTCs. Taken together, it seems likely that progression from these precursors to invasive carcinoma is a major process in biliary carcinogenesis.

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Section: Common Precursors Of the Biliary Tractmentioning

confidence: 99%

Section: Common Precursors Of the Biliary Tractmentioning

confidence: 99%

Section: Common Precursors Of the Biliary Tractmentioning

confidence: 99%

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Pathologies of Precursor Lesions of Biliary Tract Carcinoma

Nakanuma

Kakuda

Sugino

et al. 2022

Cancers

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“…Some studies have reported cases of ICPN originating from the cystic duct [ 9 , 10 , 11 ]. However, these cases include tumors that involved the common bile duct and were not localized to the cystic duct.…”

Section: Discussionmentioning

confidence: 99%

Intracholecystic Papillary Neoplasm Localized to the Cystic Duct: A Case Report

Oishi

Ikeda

Toyota

et al. 2022

Case Rep Gastroenterol

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Intracholecystic papillary neoplasm (ICPN) of the gallbladder is a premalignant lesion. An ICPN arising from the cystic duct is rare. A woman in her 60s exhibited dilatation of the common bile duct on computed tomography (CT) performed for screening of respiratory disease. The CT revealed an enhancing mass, 3.3 cm in diameter, in the cystic duct. Endoscopic ultrasonography showed a well-demarcated, hyperechoic mass in the dilated cystic duct. Endoscopic retrograde cholangiography showed that the common bile duct was slightly retracted by the dilated cystic duct. Cytological analysis of the bile juice did not show any evidence of malignancy. She was diagnosed with a cystic bile duct tumor suggestive of ICPN. Cholecystectomy, resection of the extrahepatic bile duct, and lymph node dissection were performed. Macroscopically, the papillary-proliferated tumor was localized to the cystic duct. No critical lesions were evident in the common bile duct. Histologically, the tumor in the cystic duct showed intraluminal growth with a papillary configuration without malignancy. Based on these findings, the tumor was diagnosed as an ICPN. We encountered a rare case of ICPN localized to the cystic duct of the gallbladder.

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“…The genomics of BTCs, including IPNB, has recently been de ned using advanced next-generation sequencing [14][15][16][17] . Tumor characterization based on genetic status helps identify appropriate moleculartargeted treatments, leading to individualized therapies.…”

Section: Introductionmentioning

confidence: 99%

Metachronous bile duct cancers originate from primary cancer clones

Aoki

Omori

Inoue

et al. 2022

Preprint

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Metachronous tumors arising in the remnant bile duct after surgical resection for primary biliary tract cancers (BTCs) are rarely treated surgically and have not been well documented. This study aimed to clarify the clinicopathological and genomic features of metachronous tumors arising in the remnant bile duct. Consecutive 12 patients who underwent resection for metachronous BTCs arising in the remnant bile duct after primary surgical resection between 2008 and 2020 were enrolled. Clinicopathological analysis and genomic analysis using targeted amplicon sequencing for 31 biliary tract cancer-related genes, including TP53, APC, ARID1A, ARID2, BAP1, CDKN2A, CTNNB1, ELF3, ERBB2, GNAS, IDH1, KRAS, and SMAD4, and immunohistochemistry for p53, p16, SMAD4, ARID1A, and β-catenin, were performed on 12 matched pair of primary and metachronous BTCs. In the 12 patients, 7 metachronous tumors developed antegradely in the lower portion of the biliary tree, and the remaining 5 metachronous tumors developed retrogradely in the upper portion, with negative bile duct margin at the initial operations. Molecular analysis revealed mutations and copy number alterations in TP53 (87.5%), APC (20.8%), CTNNB1 (20.8%), KRAS (12.5%), GNAS (8.3%), and RNF43 (8.3%). In comparison analysis, the matched primary and metachronous tumors shared identical genomic features in 10 cases, except in 2 cases showing metachronous perihilar and distal bile duct carcinomas after gallbladder cancer resection. Seven patients survived without recurrence, 5 showed postoperative local recurrences, and 2 died. Nine patients achieved 5-year overall survival after primary surgery. In conclusion, among the 12 patients with subsequent metachronous BTCs, 10 originated from neoplastic clones of the primary carcinoma, indicating recurrence due to intramural metastases or intraductal disseminations. Repeated surgical approach for metachronous BTCs may provide definitive local control and potentially prolong survival in these patients.

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Intracholecystic papillary neoplasm arising in the cystic duct and extending into common bile duct: a case report

Cited by 8 publications

References 12 publications

Pathologies of Precursor Lesions of Biliary Tract Carcinoma

Pathologies of Precursor Lesions of Biliary Tract Carcinoma

Intracholecystic Papillary Neoplasm Localized to the Cystic Duct: A Case Report

Metachronous bile duct cancers originate from primary cancer clones

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