Intraductal papillary neoplasm of bile duct: all rare in one

BMJ Case Rep. 2020 Nov 9;13(11):e237001. doi: 10.1136/bcr-2020-237001.

Abstract

A 45-year-old woman was referred from Department of Dermatology to Surgery outpatient department with pruritus since 6 months and an episode of jaundice that lasted for 15 days about 6 months ago. She was referred with a contrast-enhanced MRI finding that showed a small lesion in the lower end of common bile duct. Endoscopy-guided biopsy was performed twice at our hospital, the second revealed low grade dysplasia. Consequently, she underwent pancreaticoduodenectomy. Intraoperatively, there were both vascular and biliary anatomical variations that were missed on preoperative images. On histopathological examination, it turned out to be a mixed variety of intraductal papillary neoplasm of bile duct (IPNB). As all findings were rare in one, hence, we present this case of IPNB that presented to us with variable clinical, radiological, surgical and pathological findings.

Keywords: biliary intervention; gastrointestinal surgery; general surgery; pancreas and biliary tract.

Publication types

  • Case Reports

MeSH terms

  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / surgery
  • Biopsy
  • Carcinoma, Papillary / diagnosis*
  • Carcinoma, Papillary / surgery
  • Cholangiopancreatography, Magnetic Resonance / methods
  • Common Bile Duct*
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Pancreatectomy / methods
  • Pancreatic Intraductal Neoplasms / diagnosis*
  • Pancreatic Intraductal Neoplasms / surgery
  • Pancreaticoduodenectomy
  • Rare Diseases*