Advanced Intraductal Papillary Neoplasm of Bile Duct (IPNB) in a young female with metastases to lymph nodes and ovary

Abstract

A 30-year-old woman with intermittently persisting high fever from 2007 was referred to our hospital. On admission Oct 2008, she complained of high fever and back pain. CT revealed a large cystic liver tumor with papillary projections locating mainly in the left lobe. Distinct mucin secretion from papilla of Vater were observed during ERC. Under the diagnosis of IPNB with metastases to the ovary and lymph nodes, she underwent extended left lobectomy of the liver, bile duct resection, biliary reconstruction and ovariectomy because reductive surgery may appear to be beneficial. Mucinous tumor was founded on the left lobe of the liver, and metastatic lymph nodes around pancreas and paraaortic region were found. After the operation she was received chemotherapy with gemcitabine and S-1. Although metastatic lymph nodes and local recurrence were developing gradually, she is still doing well in 2 and half years after operation.