Muranushi Ryo, Saito Hideyuki, Matsumoto Asuka, Kato Toshihide, Tanaka Naritaka, Nakazato Kenji, Morinaga Nobuhiro, Shitara Yoshinori, Ishizaki Masatoshi, Yoshida Takatomo, Aishima Shinichi, Shirabe Ken
Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Gunma University, 3-39-15 Showa-Machi, Maebashi, Gunma, 371-8511, Japan.
Department of Surgery, Fujioka General Hospital, Fujioka, Gunma, Japan.
Surg Case Rep. 2018 Sep 27;4(1):124. doi: 10.1186/s40792-018-0524-2.
Intracholecystic papillary neoplasm (ICPN) is defined as papillary tumors detected macroscopically in the gallbladder. We report a case of ICPN which exhibited the atypical form like a submucosal tumor.
A 70-year-old man was admitted to our hospital because of hepatic disorder. Computed tomography and magnetic resonance imaging showed irregular thickening of the wall within the gallbladder fundus. Because the lesion might have been malignant, we performed laparoscopic cholecystectomy and liver bed resection. Macroscopic findings showed the mucosal surface of the tumor was smooth, and its form was similar to that of a submucosal tumor. Histopathological examination revealed papillary tumors within the mass with low-grade dysplasia; therefore, we diagnosed ICPN.
In the present case, ICPN was resembling a submucosal tumor macroscopically because the tumors arose into the Rokitansky-Aschoff sinus and the adenomyomatous hyperplasia was merged with the ICPN. It is necessary to consider the possibility of tumor lesions within adenomyomatous hyperplasia.
胆囊内乳头状肿瘤（ICPN）被定义为在胆囊内肉眼可见的乳头状肿瘤。我们报告一例表现为黏膜下肿瘤样非典型形态的ICPN病例。
一名70岁男性因肝脏疾病入院。计算机断层扫描和磁共振成像显示胆囊底部壁不规则增厚。由于该病变可能为恶性，我们进行了腹腔镜胆囊切除术和肝床切除术。肉眼检查发现肿瘤黏膜表面光滑，形态类似于黏膜下肿瘤。组织病理学检查显示肿块内有乳头状肿瘤伴低度异型增生；因此，我们诊断为ICPN。
在本病例中，ICPN在肉眼上类似于黏膜下肿瘤，因为肿瘤长入罗-阿窦且腺肌增生与ICPN合并。有必要考虑腺肌增生内存在肿瘤病变的可能性。
