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

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Title: An intraductal papillary neoplasm of the bile duct mimicking a hemorrhagic hepatic cyst: a case report
Authors: Kakisaka, Tatsuhiko Browse this author
Kamiyama, Toshiya Browse this author →KAKEN DB
Yokoo, Hideki Browse this author →KAKEN DB
Nakanishi, Kazuaki Browse this author →KAKEN DB
Wakayama, Kenji Browse this author
Tsuruga, Yosuke Browse this author
Kamachi, Hirofumi Browse this author →KAKEN DB
Mitsuhashi, Tomoko Browse this author →KAKEN DB
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: Hemorrhagic hepatic cyst
Intraductal papillary neoplasm of the bile duct
Oncocytic
Issue Date: 24-May-2013
Publisher: Biomed Central Ltd
Journal Title: World Journal of Surgical Oncology
Volume: 11
Publisher DOI: 10.1186/1477-7819-11-111
Abstract: 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.
Rights: http://creativecommons.org/licenses/by/2.0/
Type: article
URI: http://hdl.handle.net/2115/53039
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 武冨 紹信

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