Intracholecystic papillary neoplasm (ICPN) is a grossly visible, mass-forming, noninvasive epithelial neoplasm arising from the mucosa and projecting into the lumen of the gallbladder. ICPN is a lesser-known tumor of the gallbladder lining, which although has a better prognosis compared to gallbladder adenocarcinoma carries the potential for metastatic transformation with spread to other organs. ICPN is found incidentally on imaging or during postop histological evaluation. However, we present a unique case of ICPN that was incidentally diagnosed in a 72-year-old Eastern European woman following cholecystectomy for acute cholecystitis and was missed on preoperative imaging. Follow-up protocols of ICPN are poorly understood and vastly underreported. We discuss this patient's findings in light of current literary evidence available on ICPN and outline future directions for better clinical understanding. We also highlight the need for screening guidelines in light of known risk factors to better understand the natural history of the disease to prevent malignant transformation into invasive gallbladder carcinoma.
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http://dx.doi.org/10.7759/cureus.41222 | DOI Listing |
Clin J Gastroenterol
December 2024
Division of Gastroenterology, Department of Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama-shi, Yokohama, Kanagawa, 227-8501, Japan.
Intracholecystic papillary neoplasm and cholecystocolonic fistula are both relatively rare diseases. Here, we report a case of a preoperative intracholecystic papillary neoplasm associated with invasive carcinoma and a transverse colonic fistula of the gallbladder. A 79-year-old female patient presented to our hospital with persistent right upper quadrant pain for several months and was suspected to have intracholecystic papillary neoplasm associated with an invasive carcinoma by computed tomography and endoscopic ultrasound.
View Article and Find Full Text PDFCureus
November 2024
Department of Diagnostic Pathology, Kakogawa Central City Hospital, Kakogawa, JPN.
We report the case of a 76-year-old man who presented with pain in the right upper abdomen. Laboratory and radiological examinations revealed cholangitis, cholelithiasis, and a gallbladder tumor adhering to the transverse colon. After receiving conservative therapy for cholangitis, the patient underwent surgery for the gallbladder disease.
View Article and Find Full Text PDFCancers (Basel)
November 2024
Division of Pathology, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.
There are several types of microvasculature supplying neoplasms: "newly formed blood vessels" (neoangiogenesis), which are a component of the tumor microenvironment (TME) of invasive carcinoma with wound healing-like reaction; and "pre-existing blood vessels", which are used as tumor-supplying vessels by neoplasms (co-option vessels) and are likely to develop in hypervascularized organs. We herein review the microvasculature of neoplasms of biliary tract with reference to pre-existing vessels and vessel co-options. In the hepatobiliary system, intrahepatic large and extrahepatic bile ducts (large bile ducts) and the gallbladder as well as hepatic lobules are highly vascularized regions.
View Article and Find Full Text PDFClin Case Rep
November 2024
Department of Surgery, Acute Care Surgery Hamad Medical Corporation Doha Qatar.
Key Clinical Message: Vigilant intraoperative inspection is crucial during gallbladder surgery to detect any abnormal tissue including the rare pyloric gland adenomas, which can be easily missed. Thorough examination and removal of unusual lymph nodes or thickened tissues are essential to prevent the risk of malignant transformation and ensure comprehensive patient care.
Abstract: Pyloric gland adenomas are uncommon tumors that can be discovered in various organs such as the stomach, gallbladder, and pancreas.
Cureus
September 2024
Surgery, N.K.P. Salve Institute of Medical Sciences and Research Center, Nagpur, IND.
Intracholecystic papillary neoplasm (ICPN) is a mass-forming, noninvasive epithelial premalignant neoplasm arising from the gallbladder mucosal lining and projecting into the lumen of the gallbladder. It is potentially fatal and if left untreated can progress to invasive gallbladder carcinoma. Incidentally ICPN is found on imaging or during postoperative histological evaluation and is likely to be missed preoperatively.
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