H-Index
18
Scimago Lab
powered by Scopus
eISSN: 1941-5923
call: +1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Logo

MSMbanner
Medical Science Monitor Basic Research

Annals
ISI-Home

Low-Grade Dysplastic Intracholecystic Papillary Neoplasia: A Case Report

Challenging differential diagnosis, Rare disease

Ana Logrado, Júlio Constantino, Carlos Daniel, Jorge Pereira, Maria Teresa Carvalho, Carlos Casimiro

Portugal Department of General Surgery, Tondela-Viseu Hospital Center, Viseu, Portugal

Am J Case Rep 2021; 22:e929788

DOI: 10.12659/AJCR.929788

Available online: 2021-01-23

Published: 2021-03-03


#929788

BACKGROUND: The World Health Organization classification of premalignant gallbladder lesions includes adenomas, intraductal papillary neoplasms, biliary intraepithelial neoplasia, and intracystic papillary neoplasms. Noninvasive neoplastic lesions >1 cm that originate from the pancreatobiliary system are defined as intraductal papillary neoplasia when they occur in the biliary ducts. The clinical and pathological features of preinvasive lesions arising in the gallbladder are not yet well defined. However, the most widely accepted classification is that of intracholecystic papillary neoplasm (ICPN).
CASE REPORT: We present the case of a 71-year-old woman referred to a General Surgery outpatient clinic for suspicious findings on imaging of the gallbladder, namely irregular infundibular parietal thickening. The patient underwent a laparoscopic cholecystectomy and histological examination revealed a thickened gallbladder with mucosa partially surrounded by ICPN with an intestinal pattern and some foci of low-grade dysplasia but no foci of high-grade dysplasia or invasive neoplasia. At follow-up at 30 months, the patient remains clinically well, with no changes visible on computed tomography scan.
CONCLUSIONS: ICPN of the gallbladder appears to be part of a spectrum of alterations encompassing bile duct or pancreatic lesions. Although it is uncommon, more than half of the lesions are known to have foci of invasive neoplasia at the time of diagnosis. Despite that, the prognosis for these neoplasms is more favorable than for gallbladder neoplasia that originates from another type of lesion. Pathological study of ICPN is essential to define the main characteristics that impact prognosis and survival in these patients.

Keywords: Biliary Tract Neoplasms, Cholecystectomy, Gallbladder Neoplasms, Pathological Conditions, Anatomical



Back