2015 Volume 29 Issue 2 Pages 292-299
Intraductal papillary mucinous neoplasm (IPMN) is associated with the incidence of extrapancreatic neoplasms. However, multiple bile duct system tumors associated with IPMN is rare. An 82-year-old woman was admitted to our hospital with jaundice. CT revealed a mass in the middle bile duct, gallbladder wall thickening, and a multilocular cystic lesion in the pancreatic head. ERCP revealed an occluded middle bile duct and a communication between the main pancreatic duct and the cystic lesion. Cytology of the bile juice was class III (suspicion of Adenocarcinoma). Subsequently, the patient was diagnosed with IPMN and biliary neoplasm of middle bile duct. PPPD was performed. Histological analysis demonstrated intraductal papillary mucinous adenoma and tumors in the middle bile duct and gall bladder. Histopathologically, these tumors were completely separate, moderately differentiated tubular adenocarcinomas. CK20 immunostaining was positive in the bile duct and negative in the gall bladder. Thus, we confirmed the diagnosis as double synchronous neoplasm of the common bile duct and gallbladder.
