Gu TY, Wang SH, Yang SY, Zhao SQ, Chen MJ, Li XP, Song ZW, Gu XX, Chen F. Intraductal papillary neoplasm of the biliary tract with typical clinicopathological, endoscopic features: A case report. World J Gastrointest Surg 2025; 17(12): 112887 [DOI: 10.4240/wjgs.v17.i12.112887]
Corresponding Author of This Article
Fei Chen, PhD, Department of Surgery, The Second Affiliated Hospital of Jiaxing University, No. 1518 Huancheng North Road, Jiaxing 314000, Zhejiang Province, China. tangchouer@zjxu.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 27, 2025 (publication date) through Dec 25, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Gu TY, Wang SH, Yang SY, Zhao SQ, Chen MJ, Li XP, Song ZW, Gu XX, Chen F. Intraductal papillary neoplasm of the biliary tract with typical clinicopathological, endoscopic features: A case report. World J Gastrointest Surg 2025; 17(12): 112887 [DOI: 10.4240/wjgs.v17.i12.112887]
Tian-Yuan Gu, Si-Qi Zhao, Min-Jie Chen, Xiao-Ping Li, Zheng-Wei Song, Fei Chen, Department of Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Su-Hang Wang, Department of Pathology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Shu-Ying Yang, Xiao-Xia Gu, Department of Intensive Medicine, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Co-first authors: Tian-Yuan Gu and Su-Hang Wang.
Co-corresponding authors: Xiao-Xia Gu and Fei Chen.
Author contributions: Gu TY, Wang SH, Yang SY, Song ZW, Gu XX and Chen F designed the report; Gu TY, Yang SY and Zhao SQ were attending doctors for the patient; Song ZW performed the surgery; Wang SH performed the pathological examination; Chen MJ and Li XP performed the literature review; Gu TY and Wang SH wrote the draft; Gu XX, Song ZW and Chen F revised the manuscript for important intellectual content; all authors read and approved the final manuscript; Gu TY and Wang SH contributed equally and shared co-first authorship; Gu XX and Chen F contributed equally and shared the corresponding author.
Supported by Medical Health Science and Technology Project of Zhejiang Provincial Health Commission, No. 2022KY1246; and Science and Technology Bureau of Jiaxing City, No. 2023AZ31002.
Informed consent statement: Written informed consent was obtained from the individual for the publication of this case report and any potentially identifiable images. The patient agreed to participate in this study and to publish this report.
Conflict-of-interest statement: The authors report no conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei Chen, PhD, Department of Surgery, The Second Affiliated Hospital of Jiaxing University, No. 1518 Huancheng North Road, Jiaxing 314000, Zhejiang Province, China. tangchouer@zjxu.edu.cn
Received: August 8, 2025 Revised: October 2, 2025 Accepted: October 29, 2025 Published online: December 27, 2025 Processing time: 139 Days and 8.3 Hours
Abstract
BACKGROUND
A literature review revealed that intraductal papillary mucinous neoplasm of the biliary tract (IPMN-B) cases with characteristic clinical, imaging, endoscopic, and pathological features are exceedingly rare. Herein, we present a case of typical IPMN-B with malignant transformation that required 4 years for a definitive diagnosis, to enhance the understanding of this disease entity.
CASE SUMMARY
A 67-year-old male patient was referred to our hospital due to abdominal pain and jaundice. Four years before this admission, a cystic lesion and left hepatolithiasis were incidentally discovered. Laboratory tests revealed mild increases in serum white blood cell count, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase. Tumour marker levels were within normal limits. Imaging findings demonstrated an enlargement of the cystic tumour from 41 mm to 63 mm, along with the development of numerous enhancing papillary nodules within it, which showed hyperenhancement during the arterial phase. Duodenoscopy revealed an enlarged major duodenal papilla with a fish-mouth appearance and dilated orifice, exuding translucent jelly-like mucus. Endoscopic retrograde cholangiography demonstrated multiple cloudy, irregular filling defects within the dilated extrahepatic bile duct. Following the diagnosis of IPMN-B, left hepatectomy was performed. Postoperative histopathological examination and immunohistochemistry confirmed IPMN-B with high-grade intraepithelial neoplasia and associated invasive carcinoma.
CONCLUSION
Heightened vigilance and recognition of IPMN-B are essential when “hepatic cysts” or “biliary stones” are incidentally detected.
Core Tip: Owing to the absence of specific clinical and imaging manifestations, intraductal papillary mucinous neoplasm of the biliary tract (IPMN-B) is frequently missed or misdiagnosed when incidentally discovered. Here, we present a case of IPMN-B that exhibited characteristic clinical, imaging, endoscopic, and pathological features and progressed to malignancy. This case illustrates the 4-year latent progression of IPMN-B from an initially 'benign' cystic lesion to a malignant neoplasm, emphasizing the importance of continuous monitoring for nonspecific imaging findings.
