Case of Mucus-producing Intracholecystic Papillary Neoplasm Causing Acute Obstructive Cholangitis

Abstract

A 71-year-old man presented in our clinic with a chief complaint of back and orbital pain. Previous computed tomography performed at a doctor's clinic revealed cholelithiasis and a papillary tumor in an enlarged gallbladder with mild bile duct dilatation extending from Vater's papilla to the intrahepatic bile ducts. Five days later, he returned to the emergency room due to worsening of right-sided back pain. He was admitted with obstructive jaundice and acute cholangitis. Endoscopic retrograde cholangiopancreatography was performed, and an endoscopic nasobiliary drainage tube was placed. Excessive mucus secretion quickly led to tube dysfunction, and daily saline lavage was necessary to maintain biliary drainage. He was diagnosed with intracholecystic papillary neoplasm (ICPN) from a papillary tumor in the gallbladder with mucus discharge from Vater's papilla. Complete cholecystectomy was then performed, and histopathological diagnosis showed biliary- or oncocytic-type ICPN.

We report a rare case of mucus-associated obstructive cholangitis in a patient with ICPN.