Mucinous biliary papillomatosis: a tumour in need of wider recognition

Abstract

We report three cases of mucinous biliary papillomatosis occurring high in the extra‐hepatic bile ducts. Histological assessment of malignancy is difficult and subjective because there is no unequivocal evidence of stromal invasion. Using anti‐laminin antibodies to assess the basement membranes of these tumours we have found a large number of discontinuities in the epithelial basement membrane. On this basis we consider that mucinous biliary papillomatosis should be considered a low‐grade malignancy. This would correlate with the natural history of these tumours, namely recurrence but with no widespread metastasis, death resulting from liver failure usually with 5–6 years of presentation.

Left hemihepatectomy and caudate lobectomy and complete extrahepatic bile duct resection using transduodenal approach for hilar cholangiocarcinoma arsing from Biliary Papillomatosis

“…BP is rare, and its etiology and pathogenesis remain not well known [8]. BP has been previously considered to be a benign disease with low malignant potential [9]. Recently, it has been regarded as a premalignant disease with high malignant potential and disease progression may follow the adenoma-carcinoma sequence [10].…”

Practical guide to medical student assessment

“…The latter are of doubtful specificity, however, with elevations possibly caused by cholangitis attacks 14. Another marker of tumor presence, but not necessarily of malignancy, was the initial mucin production15 that has not recurred. The papillotomy performed for transendoscopic cholangioscopy made it difficult to fill the bile ducts with contrast via the PTCD, due to rapid emptying to the duodenum.…”

Intrahepatic biliary papilloma morphologically similar to biliary cystadenoma

“…Biliary papilloma results in the tumorous papillary growth of the bile duct epithelia in the bile duct lumen. Because the lesions of biliary papilloma are usually diffuse and multiple, most previous cases have been reported as biliary papillomatosis 1–15 …”