Related Experiment Video
Updated: Jun 19, 2026
Robotic Duodenum-preserving Total Pancreatic Head Resection for Intraductal Papillary Mucinous Neoplasms
Published on: April 17, 2026
[A case of macroscopically unvisualized mucin-hypersecreting biliary papillomatosis diagnosed by microscopy]
Jong Hyeok Jeong1, Hyeuk Park, Seung Won Moon
1Department of Gastrointestinal Medicine, Saint Carollo Hospital, Suncheon, Korea.
Abstract:
The mucin-hypersecreting biliary papillomatosis is a premalignant neoplasm characterized by intraductal papillary proliferation involving extensive areas of the intrahepatic and/or extrahepatic bile duct. We report a case of mucin-hypersecreting biliary papillomatosis manifested as obstructive jaundice and diagnosed only by microscopy, with a review of literatures. A 74-year-old female, who had a past history of cholecystectomy about 13 years ago, was admitted to our hospital with jaundice. A CT scan showed marked dilatation of intrahepatic and extrahepatic bile duct without intraductal filling defect or extrabiliary mass. During endoscopic retrograde cholangiopancreatography, mucin extrusion from the duodenal major papilla and dilated common bile duct with amorphous filling defects was noted. Percutaneous transhepatic biliary drainage for cholangioscopy was failed. In the operation field, there was a lot of mucin but was no visible mass at the common bile duct with bare eyes and cholangioscopy. However, papilloma was detected at the random biopsy specimen by microscopy. The patient underwent partial resection of common bile duct and choledocho-jejunal anastomosis.
Insights
Mucin-hypersecreting biliary papillomatosis, a premalignant bile duct neoplasm, can present subtly. Diagnosis often requires microscopy due to extensive mucin and lack of visible mass, highlighting its challenging nature.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Pathology
- Oncology
Background:
- Mucin-hypersecreting biliary papillomatosis is a premalignant neoplasm.
- It involves intraductal papillary proliferation of bile ducts.
Observation:
- A 74-year-old female presented with obstructive jaundice.
- Imaging revealed dilated bile ducts but no clear mass.
- Endoscopic retrograde cholangiopancreatography showed mucin extrusion and amorphous filling defects.
Findings:
- Despite extensive mucin and lack of visible mass during surgery, microscopy confirmed papilloma.
- Diagnosis was solely dependent on random biopsy findings.
Implications:
- This case underscores the importance of microscopic examination for diagnosing biliary papillomatosis.
- Early detection and surgical intervention are crucial for managing this premalignant condition.