Biliary intraductal papillary neoplasm with metachronous multiple tumors - true multicentric tumors or intrabiliary dissemination: A case report and review of the literature

Yokode,Masataka; Yamashita,Yukimasa; Zen,Yoh

doi:10.3892/mco.2017.1139

Biliary intraductal papillary neoplasm with metachronous multiple tumors - true multicentric tumors or intrabiliary dissemination: A case report and review of the literature

Authors:
- Masataka Yokode
- Yukimasa Yamashita
- Yoh Zen
View Affiliations

Affiliations: Department of Gastroenterology and Hepatology, Kobe City Medical Center West Hospital, Kobe, Hyogo 653-0013, Japan, Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
Published online on: January 23, 2017 https://doi.org/10.3892/mco.2017.1139
Pages: 315-320
Copyright: © Yokode et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Intraductal papillary neoplasms of the bile duct (IPNBs) are recognized as a distinct type of biliary tumor. We herein discuss the possible mechanisms underlying the development of multiple tumors in patients with IPNBs through a case presentation and literature review. A 64-year-old woman initially underwent extended right hepatectomy for IPNB in the right hepatic duct. Although the surgical margin of the common bile duct was tumor-free, recurrence was detected in the intrapancreatic bile duct 26 months later. Both tumors had similar histopathological characteristics (intestinal-type IPNB with high-grade dysplasia, but no invasive cancer). A literature review identified 9 additional cases of multiple IPNBs. Unlike conventional IPNBs, which typically affect the intrahepatic or hilar bile duct, 80% of recurrent multiple tumors developed in the extrahepatic bile duct. Although multicentric tumors have been suggested in such cases, the intrabiliary dissemination of tumor cells appears to be more likely, as the majority of recurrent tumors develop in more distal parts of the bile duct compared with the primary tumor.

View Figures

View References

1	Zen Y, Fujii T, Itatsu K, Nakamura K, Minato H, Kasashima S, Kurumaya H, Katayanagi K, Kawashima A, Masuda S, et al: Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas. Hepatology. 44:1333–1343. 2006. View Article : Google Scholar : PubMed/NCBI
2	Zen Y, Sasaki M, Fujii T, Chen TC, Chen MF, Yeh TS, Jan YY, Huang SF, Nimura Y and Nakanuma Y: Different expression patterns of mucin core proteins and cytokeratins during intrahepatic cholangiocarcinogenesis from biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct-an immunohistochemical study of 110 cases of hepatolithiasis. J Hepatol. 44:350–358. 2006. View Article : Google Scholar : PubMed/NCBI
3	Ohtsuka M, Shimizu H, Kato A, Yoshitomi H, Furukawa K, Tsuyuguchi T, Sakai Y, Yokosuka O and Miyazaki M: Intraductal papillary neoplasms of the bile duct. Int J Hepatol. 2014:4590912014. View Article : Google Scholar : PubMed/NCBI
4	Zen Y, Fujii T, Itatsu K, Nakamura K, Konishi F, Masuda S, Mitsui T, Asada Y, Miura S, Miyayama S, et al: Biliary cystic tumors with bile duct communication: A cystic variant of intraductal papillary neoplasm of the bile duct. Mod Pathol. 19:1243–1254. 2006. View Article : Google Scholar : PubMed/NCBI
5	Paik KY, Heo JS, Choi SH and Choi DW: Intraductal papillary neoplasm of the bile ducts: The clinical features and surgical outcome of 25 cases. J Surg Oncol. 97:508–512. 2008. View Article : Google Scholar : PubMed/NCBI
6	Kang MJ, Jang JY, Lee KB, Han IW and Kim SW: Impact of macroscopic morphology, multifocality, and mucin secretion on survival outcome of intraductal papillary neoplasm of the bile duct. J Gastrointest Surg. 17:931–938. 2013. View Article : Google Scholar : PubMed/NCBI
7	Jung G, Park KM, Lee SS, Yu E, Hong SM and Kim J: Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct. J Hepatol. 57:787–793. 2012. View Article : Google Scholar : PubMed/NCBI
8	Lee SS, Kim MH, Lee SK, Jang SJ, Song MH, Kim KP, Kim HJ, Seo DW, Song DE, Yu E, et al: Clinicopathologic review of 58 patients with biliary papillomatosis. Cancer. 100:783–793. 2004. View Article : Google Scholar : PubMed/NCBI
9	Rocha FG, Lee H, Katabi N, DeMatteo RP, Fong Y, D'Angelica MI, Allen PJ, Klimstra DS and Jarnagin WR: Intraductal papillary neoplasm of the bile duct: A biliary equivalent to intraductal papillary mucinous neoplasm of the pancreas? Hepatology. 56:1352–1360. 2012. View Article : Google Scholar : PubMed/NCBI
10	Yeh TS, Tseng JH, Chiu CT, Liu NJ, Chen TC, Jan YY and Chen MF: Cholangiographic spectrum of intraductal papillary mucinous neoplasm of the bile ducts. Ann Surg. 244:248–253. 2006. View Article : Google Scholar : PubMed/NCBI
11	Hirano H, Nakamura M, Yoshikawa T, Araida T, Azuma T, Ohta T, Takasaki K and Hanyu F: A Recent Case of Mucin-producing Distal Bile Duct Carcinoma Recurred 3 Years after Resection of Mucin-producing Intrahepatic Bile Duct Carcinoma. Tan to Sui. 17:497–502. 1996.(In Japanese).
12	Fujioka M, Mitsui T, Terada T, Takehara A, Uno A, Kawaguchi M, Munemoto Y, Asada Y, Miura S and Zen Y: A Case of Biliary Papillomatosis with Asynchronous Recurrence. Tan to Sui. 28:231–236. 2007.(In Japanese).
13	Kurahara H, Shinchi H, Mataki Y, Maeda S, Natsugoe S and Takao S: A long-term survival case of mucin-producing bile duct carcinoma treated with repetitive surgical procedure. Jpn J Gastroenterol Surg. 42:510–515. 2009.(In Japanese). View Article : Google Scholar
14	Fukuda S, Koide K, Mukai S, Oishi K, Fujisaki S, Arita M, Sakimoto H, Eto T and Takahashi M: A case of biliary papillomatosis with asynchronous recurrence after curative operation. Jpn J Gastroenterol Surg. 43:815–821. 2010.(In Japanese). View Article : Google Scholar
15	Ito E, Watanabe J, Hatano M, Kushihata F and Takada Y: A case of intraductal papillary neoplasm of bile duct, which recurred 4 years after primary curative resection. J Jpn Surg Assoc. 74:791–796. 2013.(In Japanese). View Article : Google Scholar
16	Sato H, Sato Y, Harada K, Sasaki M, Hirano K and Nakanuma Y: Metachronous intracystic and intraductal papillary neoplasms of the biliary tree. World J Gastroenterol. 19:6125–6126. 2013. View Article : Google Scholar : PubMed/NCBI
17	Miyata T, Kawamukai J, Sakurai K, Terakawa H, Matsui D, Watanabe T, Kawahara Y, Kinoshita J, Amaya S, Terada I, et al: A Case of Intraductal Papillary Neoplasm of Bile Duct, which Recurred 2 Times after Primary Curative Resection. Tan to Sui. 35:1319–1326. 2014.(In Japanese).
18	Ohgi K, Sugiura T, Kanemoto H, Okamura Y, Ito T, Kuribara T, Asida R, Sasaki K, Nakamura Y and Uesaka K: A case of intraductal papillary neoplasm of the bile duct recurred at the remnant lower bile duct after curative liver resection. JJBA. 29:271–278. 2015.(In Japanese).
19	Narita M, Endo B, Mizumoto Y, Matsusue R, Hata H, Yamaguchi T, Otani T and Ikai I: Multicentric recurrence of intraductal papillary neoplasms of bile duct in the remnant intrahepatic bile duct after curative resection. Int J Surg Case Rep. 12:123–127. 2015. View Article : Google Scholar : PubMed/NCBI
20	Fujikura K, Fukumoto T, Ajiki T, Otani K, Kanzawa M, Akita M, Kido M, Ku Y, Itoh T and Zen Y: Comparative clinicopathological study of biliary intraductal papillary neoplasms and papillary cholangiocarcinomas. Histopathology. (In press). PubMed/NCBI
21	Matsubara A, Nara S, Sekine S, Ojima H, Kosuge T, Shimada K, Kushima R, Kanai Y and Hiraoka N: Intraductal dissemination of papillary adenocarcinoma of the ampulla of Vater in the pancreatic duct. Pathol Int. 64:39–44. 2014. View Article : Google Scholar : PubMed/NCBI