A Rare Case of Intraductal Papillary Mucinous Neoplasm of Biliary Duct in a Patient With Prostate Adenocarcinoma

Abstract Background We experienced a rare case of intraductal papillary mucinous neoplasm arising from Santorini’s duct (SD) forming a tumor protruding into the duodenum . Case presentation A 71-year-old woman was incidentally diagnosed with a 3 cm type Isp polypoid tumor in the second portion of the duodenum at another hospital. Enhanced CT and endoscopic ultrasound revealed that the origin of this protruding tumor was arising from SD and that the tumor mimicked a pedunculated duodenal tumor. Our preoperative diagnosis was a malignant pancreatic tumor arising from SD with invasion into the duodenum. She underwent a subtotal stomach-preserving pancreaticoduodenectomy, and the resected specimen showed a 25 mm tumor protruding into the duodenum with a villous surface. The pathological findings revealed that the tumor was intraductal papillary mucinous adenoma (IPMA) arising from SD. Conclusions To the best of our knowledge, this is the first case of IPMA protruding into the duodenal lumen from SD, although most of the tumors arising from SD have been reported to be malignant.

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Intraductal Papillary Mucinous Neoplasm of the Pancreas Arising in the Setting of an Intermixed Acinar Cell Cystadenoma of the Pancreas: Report of a Rare Case

Case Reports in Pancreatic Cancer ◽

10.1089/crpc.2016.0018 ◽

2016 ◽

Vol 2 (1) ◽

pp. 75-78 ◽

Cited By ~ 2

Author(s):

Benjamin B. Scott ◽

Thea P. Price ◽

Zachary M. Callahan ◽

Justin S. Poling ◽

Harish Lavu

Keyword(s):

Acinar Cell ◽

Intraductal Papillary Mucinous Neoplasm ◽

Rare Case ◽

Mucinous Neoplasm

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Ascitic fluid cytology in a rare case of pseudomyxoma peritonei originating from intraductal papillary mucinous neoplasm of the pancreas

Cytopathology ◽

10.1111/j.1365-2303.2008.00617.x ◽

2009 ◽

Vol 20 (4) ◽

pp. 271-273 ◽

Cited By ~ 10

Keyword(s):

Ascitic Fluid ◽

Intraductal Papillary Mucinous Neoplasm ◽

Pseudomyxoma Peritonei ◽

Rare Case ◽

Mucinous Neoplasm ◽

Fluid Cytology

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A Rare Case of Intraductal Papillary Mucinous Neoplasm of the Biliary Duct in a Patient with Prostate Adenocarcinoma

Case Reports in Gastroenterology ◽

10.1159/000450539 ◽

2016 ◽

Vol 10 (3) ◽

pp. 743-748

Author(s):

Ravish Parekh ◽

Gregory Krol ◽

Cyrus Piraka ◽

Surinder Batra

Keyword(s):

Soft Tissue ◽

Intraductal Papillary Mucinous Neoplasm ◽

Hepatic Duct ◽

Prostate Adenocarcinoma ◽

Common Hepatic Duct ◽

Left Hepatic Duct ◽

Ductal System ◽

Mucinous Neoplasm ◽

The Common ◽

The Right

Intraductal papillary mucinous neoplasms (IPMNs) are mucin-producing papillary neoplasms of the pancreatic or biliary ductal system that exhibit variable cellular atypia and cause ductal dilation. There are few reported cases of IPMN arising from the biliary tree in the literature. It has a higher propensity to undergo malignant transformation compared to IPMN arising from the pancreatic duct. An 80-year-old male underwent cross-sectional tomography (CT) imaging of the abdomen for evaluation of prostate adenocarcinoma, which revealed an incidental 2.3 × 2.7 cm soft tissue mass centered at the porta hepatis with diffuse dilatation of the left intrahepatic biliary ductal system and mild prominence of the right intrahepatic ductal system. Endoscopic ultrasound showed 2 adjacent hilar masses involving the common hepatic duct and the left hepatic duct with protrusion of the tissue into the lumen of the duct and upstream ductal dilatation. Endoscopic retrograde cholangiopancreatography revealed a large filling defect in the common hepatic duct extending into the left hepatic duct. A large amount of clot and soft tissue with a fish-egg appearance was retrieved. The patient underwent left hepatic lobectomy, radical resection of the common hepatic duct with Roux-en-Y hepaticojejunostomy to the right hepatic duct. Histopathological examination of the resected specimen revealed intraductal papillary mucinous neoplasm with diffuse high-grade dysplasia. Follow-up CT scan of the abdomen 2 months after the surgery was negative for any masses.

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