Intraductal Papillary Neoplasm of the Bile Duct Posing Diagnostic and Therapeutic Challenges

Intraductal papillary neoplasms of the bile duct are rare tumors with fibrovascular stalks arising from the bile duct. It is often difficult to diagnose preoperatively, especially from mucinous cystic neoplasms. The incidence is more common in Asian countries and rare in Western countries. We report a series of patients with Intraductal papillary neoplasms of the bile duct and describe challenges faced during diagnosis and subsequent management. All the patients differed in clinical and radiological presentation and hence required different approaches to management. The first two cases presented as a space-occupying lesion of the liver, and the third one was a periampullary lesion. All were managed with surgical resection. These neoplasms are uncommon in India and often pose diagnostic and therapeutic difficulties. As the spectrum of presentation varies from benign neoplasm to invasive carcinoma, surgical resection should be performed as it offers the possibility of a cure.