Natov NS, Horton LC, Hegde SR. Successful endoscopic treatment of an intraductal papillary neoplasm of the bile duct. World J Gastrointest Endosc 2017; 9(5): 238-242 [PMID: 28572878 DOI: 10.4253/wjge.v9.i5.238]
Corresponding Author of This Article
Nikola S Natov, MD, Gastroenterology Fellow, the Gastroenterology/Hepatology Division, Tufts Medical Center, 800 Washington Street, #233, Boston, MA 02111, United States. nnatov@tuftsmedicalcenter.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
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Natov NS, Horton LC, Hegde SR. Successful endoscopic treatment of an intraductal papillary neoplasm of the bile duct. World J Gastrointest Endosc 2017; 9(5): 238-242 [PMID: 28572878 DOI: 10.4253/wjge.v9.i5.238]
World J Gastrointest Endosc. May 16, 2017; 9(5): 238-242 Published online May 16, 2017. doi: 10.4253/wjge.v9.i5.238
Successful endoscopic treatment of an intraductal papillary neoplasm of the bile duct
Nikola S Natov, Laura C Horton, Sanjay R Hegde
Nikola S Natov, Sanjay R Hegde, the Gastroenterology/Hepatology Division, Tufts Medical Center, Boston, MA 02111, United States
Laura C Horton, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115-6110, United States
Author contributions: Natov NS and Hegde SR participated equally in conception, acquisition, and analysis of data in the creation of the manuscript; Horton LC assisted with analysis of data and revision.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards of Tufts University School of Medicine and Tufts Medical Center.
Informed consent statement: The subject provided written informed consent prior to planned treatments.
Conflict-of-interest statement: The authors report no financial or other conflicts of interest (including but not limited to commercial, personal, political, intellectual, or religious interests).
Correspondence to: Nikola S Natov, MD, Gastroenterology Fellow, the Gastroenterology/Hepatology Division, Tufts Medical Center, 800 Washington Street, #233, Boston, MA 02111, United States. nnatov@tuftsmedicalcenter.org
Telephone: +1-617-6365883 Fax: +1-617-6369292
Received: October 19, 2016 Peer-review started: October 23, 2016 First decision: December 1, 2016 Revised: December 27, 2016 Accepted: January 11, 2017 Article in press: January 14, 2017 Published online: May 16, 2017 Processing time: 208 Days and 12.4 Hours
Abstract
We present a case of a 76-year-old man with right upper quadrant abdominal pain and weight loss, who was found to have an intraductal papillary neoplasm of the bile duct (IPNB) of the pancreaticobiliary subtype, deemed curatively resectable. The patient declined surgery and opted for endoscopic therapy. He underwent two sessions of endoscopic retrograde cholangiopancreatography (ERCP)-guided radiofrequency ablation (RFA). Ten months later, no evidence of recurrence was identified on repeat ERCP. To our knowledge, this is the first reported case of successful use of RFA as a primary treatment modality for resectable IPNB.
Core tip: Intraductal neoplasms of the bile duct (IPNB) classically present with jaundice and/or pruritus, but nonspecific symptoms such as right upper quadrant discomfort and weight loss may also develop. The first-line treatment for these tumors is surgical resection. Endoscopic retrograde cholangiopancreatography-guided radiofrequency ablation (RFA) has historically been used as adjunctive treatment; self-expanding metal stents may be used for palliation. We report a case of successful primary treatment of an IPNB with RFA alone.
