Arfan Sara, Sharma Kapish, Anbazhagan Lavanyah, Stear Timothy J
Department of Surgery, Windsor University School of Medicine, Cayon, KNA.
Department of Surgery, Community First Medical Center, Chicago, USA.
Cureus. 2023 Jun 30;15(6):e41222. doi: 10.7759/cureus.41222. eCollection 2023 Jun.
Intracholecystic papillary neoplasm (ICPN) is a grossly visible, mass-forming, noninvasive epithelial neoplasm arising from the mucosa and projecting into the lumen of the gallbladder. ICPN is a lesser-known tumor of the gallbladder lining, which although has a better prognosis compared to gallbladder adenocarcinoma carries the potential for metastatic transformation with spread to other organs. ICPN is found incidentally on imaging or during postop histological evaluation. However, we present a unique case of ICPN that was incidentally diagnosed in a 72-year-old Eastern European woman following cholecystectomy for acute cholecystitis and was missed on preoperative imaging. Follow-up protocols of ICPN are poorly understood and vastly underreported. We discuss this patient's findings in light of current literary evidence available on ICPN and outline future directions for better clinical understanding. We also highlight the need for screening guidelines in light of known risk factors to better understand the natural history of the disease to prevent malignant transformation into invasive gallbladder carcinoma.
胆囊内乳头状瘤(ICPN)是一种肉眼可见的、形成肿块的、非侵袭性上皮性肿瘤,起源于黏膜并突入胆囊腔。ICPN是一种较少见的胆囊内衬肿瘤,尽管与胆囊腺癌相比预后较好,但有转移至其他器官的潜在可能。ICPN通常在影像学检查或术后组织学评估中偶然发现。然而,我们报告了一例独特的ICPN病例,该病例是在一名72岁东欧女性因急性胆囊炎行胆囊切除术后偶然诊断出来的,术前影像学检查未发现。ICPN的随访方案了解甚少且报道严重不足。我们根据目前关于ICPN的文献证据讨论该患者的检查结果,并概述未来更好地进行临床理解的方向。我们还强调鉴于已知风险因素制定筛查指南的必要性,以更好地了解疾病的自然史,预防其恶变为浸润性胆囊癌。