A Case of Biliary Papillomatosis with Asynchronous Recurrence after Curative Operation

Saburo Fukuda, Kei Koide¹⁾, Syouichiro Mukai, Kouichi Oishi²⁾, Seiji Fujisaki, Michinori Arita, Hideto Sakimoto, Takaaki Eto and Makoto Takahash

Department of Surgery, Chugokurousai Hospital
Department of Surgery, Chuden Hospital¹⁾
Department of Surgery, Tsuchiya General Hospital²⁾

A 68-year-old woman seen for liver dysfunction and intrahepatic dilation of the left lobe found in ERCP to have a filling defect of the left hepatic duct, necessitating hilar cholangiocarcinoma surgery. Intraoperative cholangioscopy showed that the papillary tumor originated from the left hepatic duct, but had not spread to either the common or the right hepatic duct, resulfing in left hepatectomy with caudate lobectomy. Histopathologically, the resected specimen showed papillary proliferation of the bile duct epithelium consisting of columnar epithelial cells arranged in a single layer. No invasive lesion was recognized under submucosa. The tumor was diagnosed as biliary papillomatosis. In regular 6-month computed tomography (CT), a weakly stained mass was found in the lower CBD, confirmed by MRCP and ERC. Lower CBD cancer was suspected, necessitating pancreatoduodenectomy. Histological examination showed recurnent biliary papillomatosis. Biliary papillomatosis is a rare tumor categorized as benign, but should be followed up for asynchronous recurrence.

Key words
biliary papillomatosis, asynchronous recurrence, treatment

Reprint requests
Saburo Fukuda Department of Surgery, Chugokurousai Hospital
1-5-1 Hirotagaya, Kure, 787-0193 JAPAN

Accepted
November 18, 2009

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