Abstract
The patient was a 59-year-old woman. She underwent US screening during a mass examination, and a massive lesion was detected in the hepatic hilum. She was referred to our hospital.
US revealed a hyperechoic tumor 10mm in diameter in the left hepatic duct, but there was no dilatation of the intrahepatic duct. Computed tomography (CT) revealed bile duct wall thickening in the same position. EUS depicted a relatively homogeneous high echoic papillary tumor lesion, while retaining the external high echoic layer. Hence, we diagnosed a papillary tumor localized in the bile duct. Peroral cholangioscopy (POCS) shows the papillary tumor in the left hepatic duct, and the biopsy revealed hyperplasia epithelium. As the possibility of adenoma-carcinoma in situ could not be ruled out, the patient underwent left lobe, caudate lobe hepatectomy and extrahepatic bile duct resection. Pathological findings finally revealed a diagnosis of gastric type IPNB with adenoma.
