2025 Volume 39 Issue 2 Pages 229-236
The patient was an 82-year-old man. He was presented with abdominal discomfort. Abdominal sonography revealed a mass in the lateral segment of the liver. Contrast-enhanced computed tomography (CT) exposed a 40mm cystic lesion with an internal nodule. A portion of the liver parenchyma contiguous to the nodule showed a delayed contrast effect on contrast-enhanced CT and a defect on contrast-enhanced ultrasonography with Kupffer imaging. Magnetic Resonance Imaging (MRI) exhibited low signal intensity on T1-weighted images, high signal intensity on T2-weighted images with restricted diffusion, and FDG-PET indicated accumulation in the same area. A preoperative diagnosis of cystic adenocarcinoma of the liver was made. Consequently, laparoscopic surgery was performed. The postoperative pathological analysis confirmed type 1 and classified it into a biliopancreatic subtype with invasive IPNB. One year later, there was a recurrence of lymph node metastasis, leading to surgical intervention. Subsequently, one-year post-reoperation, the patient is presently undergoing regular outpatient follow-up with no signs of recurrence. Notably, recent pathological investigations of IPNB have delineated four subtypes and two classifications. We report a rare case of type 1 biliopancreatic IPNB of peripheral intrahepatic origin with stromal infiltration and a characteristic case with a well-defined infiltrated area on imaging examination.
