Intraductal papillary neoplasm of bile ducts: report of a case and literature review

Abstract

A 67 year old male with right upper quadrant abdominal pain diagnosed with intraductal papillary neoplasm of bile ducts (IPNB) by endoscopic biopsy. The patient was treated surgically and disease free on first year follow-up. Intraductal papillary neoplasm of bile duct (IPNB) is a rare entity with malignant counterparts and recently classified by The World Health Organization. The aim of this study is to present a case of IPNB and review the literature. Pubmed/MEDLINE was searched and articles were extracted. Twenty four case reports and 17 retrospective case series were evaluated. From 41 studies, 824 cases were included. There was slight male predominancy among patients and almost all cases were from eastern countries. Even though the etiology remains unclear, hepatolithiasis was the most common potential etiological association. Most cases were treated with surgical intervention. More than half of the 577 resected specimens had invasive component. Incidence rate of histopathological subtypes were as fallowed: Intestinal (35%), pancreaticobiliary (32%), gastric (19%) and oncocytic (12%). Intraductal papillary neoplasm of bile duct has an increased malignancy rates at postoperative pathological diagnosis, consequently early surgical management is important.