Extrahepatic Intraductal Papillary Neoplasms of Bile Duct and Klatskin Tumor: Simultaneous Occurrence and Recurrence?

This case report presents a 64-year-old woman with unique occurrence and recurrence of 2 different neoplastic entities, extrahepatic intraductal papillary neoplasm of bile duct and Klatskin tumor (hilar cholangiocarcinoma or central bile duct carcinoma), found simultaneously in close proximity. To date, this coexistence and recurrence with long survival time has not been reported. The patient in this case is remarkable for both the combination of intraductal papillary neoplasm of bile duct and cholangiocarcinoma, confirmed with specimen from the first surgical intervention in 2005, and recurrence of both tumors after 15 years and the patient's extraordinary survival with histological proven liver cirrhosis Child-Pugh class A. This case highlights the possibility of simultaneous occurrence and late recurrence of different neoplasms in the bile duct system and calls attention to the need for consideration in atypical cases.