Multiple intraductal papillary neoplasms of bile duct diagnosed based on endoscopic ultrasonography and peroral cholangioscopy findings

• DOI: 10.1007/s12328-024-02000-2
• Publication Date: 2024-07-06T19:01:47Z
• Authors: Masaki Onoe; Nobuhiko Fukuba; Yasuhide Kodama; Akihiko Oka; Kousaku Kawashima; Kotaro Shibagaki; Norihisa Ishimura; Yoshinori Kushiyama; Yasushi Uchida; Toru Furukawa; Shunji Ishihara
• Keywords: Male; Adult; 0301 basic medicine; 0303 health sciences; Cholangiopancreatography, Magnetic Resonance; Case Report; Endosonography; Neoplasms, Multiple Primary; Bile Ducts, Intrahepatic; Bile Duct Neoplasms; Humans; Endoscopy, Digestive System

AbstractA man in his 30s was referred to our department for evaluation of bile duct stricture and removal of an intrahepatic bile duct stone. Five years before his presentation, he underwent left hepatectomy for a giant hepatic hemangioma. There were no abnormalities in blood biochemical tests. Magnetic resonance cholangiopancreatography showed one 5 mm oval defect in region B6 and two 8 mm semicircular defects in the hilar bile duct. Endoscopic ultrasound revealed a 3.5 mm hypoechoic focal raised lesion in the hilar bile duct. Oral cholangioscopy revealed his two lesions in the hilar bile duct as white papillary elevations with mucus production. The pathological diagnosis of intraductal papillary neoplasm was determined (low-grade dysplasia, type 1, gastric type). After 1 and a half years, no expansion of the bile duct lesion was observed. Initially, it was thought to be a benign stenosis after liver resection, but based on the results of endoscopic ultrasound, we suspected a tumorous lesion, and we were able to make an accurate diagnosis, including histological type, using transoral cholangioscopy.