Table of Contents    
Case Report
 
Intraductal papillary neoplasm of extrahepatic biliary tract with an associated early invasive adenocarcinoma
Jayathilaka Karunanayake Hiroshi1, Siriwardhana Rohan2, Nawaratne NMM3, Mahendra Gayana4, Liyanage Chandika5
1MBBS, Hepatobiliary Division, Department of Surgery, Faculty of Medicine, University of Kelaniya, Sri Lanka.
2MBBS, MS, MRCS, Hepatobiliary Division, Department of Surgery, Faculty of Medicine, University of Kelaniya, Sri Lanka.
3MBBS, MD, MRCP, Department of Gastroenterology and Hepatology, National Hospital of -Sri Lanka.
4MBBS, MD Histopath, Department of Pathology, Faculty of Medicine, University of Kelaniya, Sri Lanka.
5MBBS, MPhil, MS, MRCS, Hepatobiliary Division, Department of Surgery, Faculty of Medicine, University of Kelaniya, Sri Lanka.

Article ID: 100016IJHPDJKH2014
doi:10.5348/ijhpd-2014-13-CR-1

Address correspondence to:
Karunanayake Gayathri Hiroshi Jayathilake
Department of Surgery
North Colombo teaching hospital
Ragama
Sri Lanka
Phone: +94772201962
Email: g.hiroshi@yahoo.com

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How to cite this article:
Hiroshi JK, Rohan S, Nawaratne NMM, Gayana M, Chandika L. Intraductal papillary neoplasm of extrahepatic biliary tract with an associated early invasive adenocarcinoma. Int J Hepatobiliary Pancreat Dis 2014;4:1–6.


Abstract
Introduction: Intraductal papillary neoplasm of the bile duct is a premalignant lesion, which can develop into an adenocarcinoma. If treated early, at the non-invasive stage, it has an excellent prognosis compared to cholangiocarcinoma.
Case Report: A 61-year-old female presented with intermittent episodes of fever with chills and rigors, loss of appetite, pruritus, tea colored urine, and pale sticky stools for two years duration. After work up she underwent a left hemihepatectomy with resection of caudate lobe and extrahepatic biliary duct with lymph node clearance. Histology revealed an intraductal papillary lesion with no mucin production, expanding the common hepatic duct and the left hepatic duct, invading the subepithelial connective tissue at a focus near the distal end of the left hepatic duct. The tumor was qualified as an intraductal papillary neoplasia of pancreatobiliary type involving the extrahepatic bile duct with associated early invasive adenocarcinoma. She required no further adjuvant treatment and is disease free for one year on regular followup.
Conclusion: The objective of this article is to emphasize the necessity of early diagnosis and aggressive and complete surgical resection to achieve maximum patient survival in this curable disease.

Keywords: Extra hepatic intraductal papillary neoplsm, Biliary papillomatosis, Biliary pre malignant lesion


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Author Contributions
Karunanayake Hiroshi Jayathilake – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Rohan Siriwardhane – Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
NMM Nawarathne – Conception and design, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published
Gayana Mahendra – Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Chandika Liyanage – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2014 Jayathilaka Karunanayake Hiroshi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.