Rare event of biliary papillomatosis arising in a choledochal cyst

Kumar, Nishant; Vk, Singh; Sharma, Barun Kumar

doi:10.1136/bcr-2014-204680

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…Malign transformation of these lesions is reported in around 35-41% of patients. [12] Although choledocal cysts are more frequent in female patients, men more frequently experience papillomatosis and malign transformation. [13] As stated before, complete resection of the cyst is the only treatment for biliary tract cyst complications, but the risk of malignancy cannot be eliminated.…”

Section: Discussionmentioning

confidence: 99%

Robotic Choledocal Cyst Resection and Hepaticojejunostomy at a Case with Aberrant Hepatic Artery Sailing on the Gall Bladder

Peker¹

2018

Laparosc Endosc Surg Sci

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The incidence of cysts of the biliary system is approximately 1 in 100,000 to 150,000 in Western populations. The pathophysiology of biliary tree cysts is believed to be a result of an anomalous pancreaticobiliary junction. Although surgery is the preferred treatment for biliary tree cysts, surgical resection of the cyst does not eliminate the risk of malignancy, but rather it reduces the risk. The main goal of surgery is complete resection of the cyst and reconstruction of the biliary tree. In addition to the complexity of the procedure, variations of the biliary tree and the hepatic hilum luminal structures make the surgery more difficult for the surgeon. In this report, the case of a 46-year-old male patient is described. He presented at the clinic with a previously diagnosed choledocal cyst of Todani class 1 and a history of peptic ulcer perforation surgery. Further evaluation verified a choledocal cyst measuring 6x4 cm. Robotic complete surgical resection of the cyst and reconstruction of the biliary tree with hepaticojejunostomy was performed. During the bladder dissection, a luminal structure localized near Calot's triangle was observed and determined to be the left hepatic artery coursing over the anteromedial gall bladder and entering the liver at the level of the bladder fundus. The cyst and gall bladder were dissected while preserving the left hepatic artery. In conclusion, a minimally invasive approach for choledocal cyst resection should be performed at experienced centers because of frequent variations in both the hepatic arterial system and the biliary tract.

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Section: Discussionmentioning

confidence: 99%

Robotic Choledocal Cyst Resection and Hepaticojejunostomy at a Case with Aberrant Hepatic Artery Sailing on the Gall Bladder

Peker¹

2018

Laparosc Endosc Surg Sci

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“…Transformation to malignancy (carcinoma or adenocarcinoma) is reported in 35-41% of cases in humans (22).…”

Section: Congenital Hepatic Cysts Are Part Of a Systemic Polycystic D...mentioning

confidence: 99%

“…The gallbladder and the quadrate and right middle liver lobes were removed "en bloc" to obtain clean margins. Recurrence of papillomatosis is reported as up to 65% in human medicine (10,(22)(23). The diffuse nature of papillomatosis is responsible for the high risk of postoperative recurrence.…”

Section: Congenital Hepatic Cysts Are Part Of a Systemic Polycystic D...mentioning

confidence: 99%

Hepatic Papillomatosis in a middle-aged cat

Mponda¹,

Olivé²

2023

Preprint

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Background According to the authors’ knowledge biliary papillomatosis is a rare disease and has not yet been described in animals. Episodes of recurrent cholangitis and associated icterus have been associated with biliary papillomatosis and confirmation of diagnosis is via histopathology, where it is characterized by the proliferation of the columnar papillary epithelium of the bile ducts. This epithelium extends into the lumen, partially or completing obstructing it. Case presentation A 8-year-old neutered domestic short-hair cat was presented for evaluation of recurrent generalized muscle atrophy, abdominal distension and marked icterus. One year before presentation, the cat was diagnosed with chronic lymphocytic cholangitis associated with intrahepatic cholestasis. Treatment was initiated with prednisolone (Dermipred; Ceva) at 2mg/kg Per Os (PO) q24 for 2 weeks then reduced to 1mg/kg PO q24h and S-adenosylmethionine 20 mg/kg (Zentonil;Vetoquinol). On presentation, the cat had marked icterus and abdominal distension. Results of abdominal ultrasound revealed large fluid lesions on hepatic parenchyma with marked dilated bile ducts. An exploratory laparotomy was performed and cystic structures were identified on the right lateral and on central division of the liver. Cholecystectomy and hepatic lobectomies with omentalization at the base of the cystic structures were performed. Histopathological analysis revealed the presence of benign papillomatosis. The cat was re-examined 2 weeks after surgery at which point clinical examination was normal. Four months after surgical intervention, the cat had recurrent clinical signs, and abdominal ultrasound revealed the presence of a large volume abdominal effusion and diffuse cystic changes within the rest of the liver. At this stage the owners elected for euthanasia. Conclusion To our knowledge, this is the first description of papillomatosis in animals. The final diagnosis was biliary papillomatosis which has never been reported in cats. The diagnosis can be difficult and it’s also a rare condition in human medicine. Biliary papillomatosis should be included in the differential diagnosis of hepatic cystic-like lesions in cats.

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Rare event of biliary papillomatosis arising in a choledochal cyst

Cited by 2 publications

References 7 publications

Robotic Choledocal Cyst Resection and Hepaticojejunostomy at a Case with Aberrant Hepatic Artery Sailing on the Gall Bladder

Robotic Choledocal Cyst Resection and Hepaticojejunostomy at a Case with Aberrant Hepatic Artery Sailing on the Gall Bladder

Hepatic Papillomatosis in a middle-aged cat

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