Abstract
Bile duct papilloma is an extremely rare entity. Note has been increasingly made of the disease because it has a variety of clinicopathological characteristics and its cancer change has been sometimes reported.
A 68-year-old man complaining of jaundice had been diagnosed as having bile duct papilloma at another hospital, and had been followed up after endoscopic fistulization. Two years and 5months later, the patient was admitted to the hospital for operation because of repeated cholangitis. Histopthological study of the resected specimen revealed cholangiocarcinoma with multiple papillary projections covering the entire extrahepatic bile duct. It was inferred to be cancer change of bile duct papilloma.
There have been eight cases of the disease in Japan in a recent one decade. Most lesions in these cases were located in the intrahepatic bile duct or extrahepatic to intrahepatic bie duct, and were characterized by mucin-production or cancer change. This case had almost similar characteristics, but the lesion was localized in the extrahepatic bile duct that enabled us to perform a complete resection comprising a resection of the extrahepatic bile duct and a pylorus preserving pancreatoduodenectomy (PPPD). There has been no sign of recurrence, as of 2years and 6months after the operation.
Although bile duct papilloma is very uncommon, we have to make a correct diagnosis as well as to take careful atitude for selection of operative procedures and postoperative follow-up in terms of its possible cancer change.
