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[A Case of Low Grade Dysplastic Intracystic Papillary Neoplasm Occurred in Young Woman]
Hiroto Yamazaki1, Fumitaka Sato, Junpei Okamoto
1Dept. of Surgery, Kurobe City Hospital.
Insights
This case report details a rare instance of gallbladder intracystic papillary neoplasm (ICPN) without malignancy. The study highlights diagnostic challenges and successful surgical management of this gallbladder polyp.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Oncology
Background:
- Gallbladder polyps require monitoring due to potential for neoplastic transformation.
- Intracystic papillary neoplasm (ICPN) is a rare gallbladder lesion, often associated with malignancy.
- Distinguishing benign from malignant gallbladder polyps can be challenging with imaging alone.
Purpose of the Study:
- To report a rare case of gallbladder intracystic papillary neoplasm (ICPN) without cancerous features.
- To discuss the diagnostic difficulties and surgical approach for gallbladder ICPN.
- To contribute to the understanding of ICPN, a recently defined gallbladder neoplasm.
Main Methods:
- A 41-year-old woman with a history of primary biliary cirrhosis and gallbladder polyps underwent evaluation.
- Abdominal CT and MRI were used for polyp characterization, revealing a 10-12 mm lesion.
- Diagnostic and therapeutic laparoscopic cholecystectomy was performed.
Main Results:
- Histopathological examination of the resected gallbladder revealed a 12 mm papillary lesion.
- The lesion was diagnosed as a low-grade intracystic papillary neoplasm (ICPN).
- No invasion or positive margins were observed, indicating a non-malignant outcome.
Conclusions:
- Intracystic papillary neoplasm (ICPN) of the gallbladder is a rare entity.
- This case represents a rare instance of ICPN without malignancy, contrasting with typical presentations.
- Laparoscopic cholecystectomy is an effective treatment for diagnostic and therapeutic purposes in suspected ICPN.
Abstract:
The patient is a 41-year-old woman. She had been regularly visiting our hospital for follow-up of primary biliary cirrhosis and gallbladder polyps, but was referred to the Department of Surgery for surgery because the polyps tended to enlarge in size. Abdominal CT showed a 10 mm-sized polyp with early contrast in the body of the gallbladder, and T2-weighted abdominal MRI showed a signal defect in the gallbladder lumen consistent with a polyp, but a qualitative diagnosis was difficult. Laparoscopic cholecystectomy was performed for diagnostic and therapeutic purposes. The macroscopic findings of the resected specimen showed a 12 mm-sized papillary lesion in the body of the gallbladder, which was diagnosed as a low-grade intracystic papillary neoplasm (ICPN) on histopathologic examination. No invasion was observed and the margins were negative. ICPN is a recently defined disease that is considered similar to intraductal papillary neoplasm of bile duct (IPNB), which develops in the gallbladder. Although most of them are diagnosed with cancer, we report a rare case of IPNB without cancer.
