Intraductal papillary mucinous neoplasm of the biliary tract: A real disease?

Joshua G. Barton, David A. Barrett, Marco A. Maricevich, Thomas Schnelldorfer, Christina M. Wood, Thomas Christopher Smyrk, Todd H. Baron, Michael G. Sarr, John H. Donohue, Michael B. Farnell, Michael L. Kendrick, David M. Nagorney, Kaye M Reid Lombardo, Florencia Que

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background: Despite increasing numbers of reports, biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) is not yet recognized as a unique neoplasm. The aim of the present study was to define the presence of BT-IPMN in a large series of resected biliary neoplasms. Methods: From May 1994 to December 2006, BT-IPMN cases were identified by reviewing pathology specimens of all resected cholangiocarcinomas and other biliary neoplasms when cystic, papillary or mucinous features were cited in pathology reports. Results: BT-IPMN was identified in 23 out of 253 (9%) specimens using the strict histopathological criteria of IPMN. The most common presenting symptom was abdominal discomfort which was present in 15 patients (65%). Only one of the original operative pathology reports used the term IPMN; 16 (70%) used the terms cystic, mucinous and/or papillary. BT-IPMN was isolated to non-hilar extra-hepatic ducts in 12 (52%), intra-hepatic ducts in 6 (26%) and hilar extra-hepatic ducts in 5 patients (22%). Carcinoma was found in association with BT-IPMN in 19 patients (83%); 5-year survival was 38% after resection. Conclusion: BT-IPMN occurs throughout the intra- and extra-hepatic biliary system and can be identified readily as a unique neoplasm. Broader acceptance of BT-IPMN as a unique neoplasm may lead to a better understanding of the pathogenesis of biliary malignancies.

Original languageEnglish (US)
Pages (from-to)684-691
Number of pages8
JournalHPB
Volume11
Issue number8
DOIs
StatePublished - 2009

Fingerprint

Biliary Tract Neoplasms
Biliary Tract
Neoplasms
Common Hepatic Duct
Pathology
Cholangiocarcinoma
Liver

Keywords

  • Biliary
  • Intraductal papillary mucinous neoplasm
  • Mucinous
  • Papillary

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Barton, J. G., Barrett, D. A., Maricevich, M. A., Schnelldorfer, T., Wood, C. M., Smyrk, T. C., ... Que, F. (2009). Intraductal papillary mucinous neoplasm of the biliary tract: A real disease? HPB, 11(8), 684-691. https://doi.org/10.1111/j.1477-2574.2009.00122.x

Intraductal papillary mucinous neoplasm of the biliary tract : A real disease? / Barton, Joshua G.; Barrett, David A.; Maricevich, Marco A.; Schnelldorfer, Thomas; Wood, Christina M.; Smyrk, Thomas Christopher; Baron, Todd H.; Sarr, Michael G.; Donohue, John H.; Farnell, Michael B.; Kendrick, Michael L.; Nagorney, David M.; Lombardo, Kaye M Reid; Que, Florencia.

In: HPB, Vol. 11, No. 8, 2009, p. 684-691.

Research output: Contribution to journalArticle

Barton, JG, Barrett, DA, Maricevich, MA, Schnelldorfer, T, Wood, CM, Smyrk, TC, Baron, TH, Sarr, MG, Donohue, JH, Farnell, MB, Kendrick, ML, Nagorney, DM, Lombardo, KMR & Que, F 2009, 'Intraductal papillary mucinous neoplasm of the biliary tract: A real disease?', HPB, vol. 11, no. 8, pp. 684-691. https://doi.org/10.1111/j.1477-2574.2009.00122.x
Barton JG, Barrett DA, Maricevich MA, Schnelldorfer T, Wood CM, Smyrk TC et al. Intraductal papillary mucinous neoplasm of the biliary tract: A real disease? HPB. 2009;11(8):684-691. https://doi.org/10.1111/j.1477-2574.2009.00122.x
Barton, Joshua G. ; Barrett, David A. ; Maricevich, Marco A. ; Schnelldorfer, Thomas ; Wood, Christina M. ; Smyrk, Thomas Christopher ; Baron, Todd H. ; Sarr, Michael G. ; Donohue, John H. ; Farnell, Michael B. ; Kendrick, Michael L. ; Nagorney, David M. ; Lombardo, Kaye M Reid ; Que, Florencia. / Intraductal papillary mucinous neoplasm of the biliary tract : A real disease?. In: HPB. 2009 ; Vol. 11, No. 8. pp. 684-691.
@article{f08fb54f92304c43a572e621599e4c07,
title = "Intraductal papillary mucinous neoplasm of the biliary tract: A real disease?",
abstract = "Background: Despite increasing numbers of reports, biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) is not yet recognized as a unique neoplasm. The aim of the present study was to define the presence of BT-IPMN in a large series of resected biliary neoplasms. Methods: From May 1994 to December 2006, BT-IPMN cases were identified by reviewing pathology specimens of all resected cholangiocarcinomas and other biliary neoplasms when cystic, papillary or mucinous features were cited in pathology reports. Results: BT-IPMN was identified in 23 out of 253 (9{\%}) specimens using the strict histopathological criteria of IPMN. The most common presenting symptom was abdominal discomfort which was present in 15 patients (65{\%}). Only one of the original operative pathology reports used the term IPMN; 16 (70{\%}) used the terms cystic, mucinous and/or papillary. BT-IPMN was isolated to non-hilar extra-hepatic ducts in 12 (52{\%}), intra-hepatic ducts in 6 (26{\%}) and hilar extra-hepatic ducts in 5 patients (22{\%}). Carcinoma was found in association with BT-IPMN in 19 patients (83{\%}); 5-year survival was 38{\%} after resection. Conclusion: BT-IPMN occurs throughout the intra- and extra-hepatic biliary system and can be identified readily as a unique neoplasm. Broader acceptance of BT-IPMN as a unique neoplasm may lead to a better understanding of the pathogenesis of biliary malignancies.",
keywords = "Biliary, Intraductal papillary mucinous neoplasm, Mucinous, Papillary",
author = "Barton, {Joshua G.} and Barrett, {David A.} and Maricevich, {Marco A.} and Thomas Schnelldorfer and Wood, {Christina M.} and Smyrk, {Thomas Christopher} and Baron, {Todd H.} and Sarr, {Michael G.} and Donohue, {John H.} and Farnell, {Michael B.} and Kendrick, {Michael L.} and Nagorney, {David M.} and Lombardo, {Kaye M Reid} and Florencia Que",
year = "2009",
doi = "10.1111/j.1477-2574.2009.00122.x",
language = "English (US)",
volume = "11",
pages = "684--691",
journal = "HPB",
issn = "1365-182X",
publisher = "John Wiley and Sons Inc.",
number = "8",

}

TY - JOUR

T1 - Intraductal papillary mucinous neoplasm of the biliary tract

T2 - A real disease?

AU - Barton, Joshua G.

AU - Barrett, David A.

AU - Maricevich, Marco A.

AU - Schnelldorfer, Thomas

AU - Wood, Christina M.

AU - Smyrk, Thomas Christopher

AU - Baron, Todd H.

AU - Sarr, Michael G.

AU - Donohue, John H.

AU - Farnell, Michael B.

AU - Kendrick, Michael L.

AU - Nagorney, David M.

AU - Lombardo, Kaye M Reid

AU - Que, Florencia

PY - 2009

Y1 - 2009

N2 - Background: Despite increasing numbers of reports, biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) is not yet recognized as a unique neoplasm. The aim of the present study was to define the presence of BT-IPMN in a large series of resected biliary neoplasms. Methods: From May 1994 to December 2006, BT-IPMN cases were identified by reviewing pathology specimens of all resected cholangiocarcinomas and other biliary neoplasms when cystic, papillary or mucinous features were cited in pathology reports. Results: BT-IPMN was identified in 23 out of 253 (9%) specimens using the strict histopathological criteria of IPMN. The most common presenting symptom was abdominal discomfort which was present in 15 patients (65%). Only one of the original operative pathology reports used the term IPMN; 16 (70%) used the terms cystic, mucinous and/or papillary. BT-IPMN was isolated to non-hilar extra-hepatic ducts in 12 (52%), intra-hepatic ducts in 6 (26%) and hilar extra-hepatic ducts in 5 patients (22%). Carcinoma was found in association with BT-IPMN in 19 patients (83%); 5-year survival was 38% after resection. Conclusion: BT-IPMN occurs throughout the intra- and extra-hepatic biliary system and can be identified readily as a unique neoplasm. Broader acceptance of BT-IPMN as a unique neoplasm may lead to a better understanding of the pathogenesis of biliary malignancies.

AB - Background: Despite increasing numbers of reports, biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) is not yet recognized as a unique neoplasm. The aim of the present study was to define the presence of BT-IPMN in a large series of resected biliary neoplasms. Methods: From May 1994 to December 2006, BT-IPMN cases were identified by reviewing pathology specimens of all resected cholangiocarcinomas and other biliary neoplasms when cystic, papillary or mucinous features were cited in pathology reports. Results: BT-IPMN was identified in 23 out of 253 (9%) specimens using the strict histopathological criteria of IPMN. The most common presenting symptom was abdominal discomfort which was present in 15 patients (65%). Only one of the original operative pathology reports used the term IPMN; 16 (70%) used the terms cystic, mucinous and/or papillary. BT-IPMN was isolated to non-hilar extra-hepatic ducts in 12 (52%), intra-hepatic ducts in 6 (26%) and hilar extra-hepatic ducts in 5 patients (22%). Carcinoma was found in association with BT-IPMN in 19 patients (83%); 5-year survival was 38% after resection. Conclusion: BT-IPMN occurs throughout the intra- and extra-hepatic biliary system and can be identified readily as a unique neoplasm. Broader acceptance of BT-IPMN as a unique neoplasm may lead to a better understanding of the pathogenesis of biliary malignancies.

KW - Biliary

KW - Intraductal papillary mucinous neoplasm

KW - Mucinous

KW - Papillary

UR - http://www.scopus.com/inward/record.url?scp=73449139399&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73449139399&partnerID=8YFLogxK

U2 - 10.1111/j.1477-2574.2009.00122.x

DO - 10.1111/j.1477-2574.2009.00122.x

M3 - Article

C2 - 20495637

AN - SCOPUS:73449139399

VL - 11

SP - 684

EP - 691

JO - HPB

JF - HPB

SN - 1365-182X

IS - 8

ER -