Intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: A case report

INTRODUCTION: Intraductal papillary mucinous neoplasm of the biliary tract (IPNB) is a rare, low-grade neoplasm limited to the bile duct mucosa. The malignant transformation rate is low, and there have been limited reports of metastasis to other organs. Herein, we presented a rare case of a patient...

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Autores principales: Lee, Joo Hyung, Kim, Hyung Sun, Park, Ji Hyun, Park, Joon Seong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837973/
https://www.ncbi.nlm.nih.gov/pubmed/33546060
http://dx.doi.org/10.1097/MD.0000000000024310
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author Lee, Joo Hyung
Kim, Hyung Sun
Park, Ji Hyun
Park, Joon Seong
author_facet Lee, Joo Hyung
Kim, Hyung Sun
Park, Ji Hyun
Park, Joon Seong
author_sort Lee, Joo Hyung
collection PubMed
description INTRODUCTION: Intraductal papillary mucinous neoplasm of the biliary tract (IPNB) is a rare, low-grade neoplasm limited to the bile duct mucosa. The malignant transformation rate is low, and there have been limited reports of metastasis to other organs. Herein, we presented a rare case of a patient who was diagnosed with IPNB concurrent with invasive adenocarcinoma after surgery and was diagnosed with cardiac metastasis 6 months later. PATIENT CONCERNS: A 61-year-old male patient presented with abdominal pain to a local clinic. He was diagnosed with intrahepatic cholangiocarcinoma with pancreatitis and transferred to our hospital. DIAGNOSIS: Diagnostic testing (magnetic resonance imaging, endoscopic retrograde cholangiopancreatography, positron emission tomography-computed tomography) revealed a papillary neoplasm and invasive adenocarcinoma with papillary neoplasm in the periampullary lesion. INTERVENTIONS: Pancreaticoduodenectomy, right hemihepatectomy, and left lateral sectionectomy of the liver were performed. After surgery, we planned gemcitabine-based adjuvant chemotherapy. OUTCOMES: Upon completion of the sixth gemcitabine chemotherapy cycle, a hyperechoic, oval-shaped mass (1.3 × 2.6 cm) was found on the outer wall of the right atrium. Resection of a cardiac tumor in the right atrium and patch repair were performed. CONCLUSION: To our knowledge, no other case of cardiac metastasis found during observation after surgery for an IPNB has been described. IPNBs are known to be less aggressive and to have a lower metastasis rate than intraductal papillary mucinous neoplasms; therefore, the number of case reports describing metastasis after surgery is relatively low. Our case suggests that close observation is necessary in patients diagnosed with an IPNB.
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spelling pubmed-78379732021-01-27 Intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: A case report Lee, Joo Hyung Kim, Hyung Sun Park, Ji Hyun Park, Joon Seong Medicine (Baltimore) 7100 INTRODUCTION: Intraductal papillary mucinous neoplasm of the biliary tract (IPNB) is a rare, low-grade neoplasm limited to the bile duct mucosa. The malignant transformation rate is low, and there have been limited reports of metastasis to other organs. Herein, we presented a rare case of a patient who was diagnosed with IPNB concurrent with invasive adenocarcinoma after surgery and was diagnosed with cardiac metastasis 6 months later. PATIENT CONCERNS: A 61-year-old male patient presented with abdominal pain to a local clinic. He was diagnosed with intrahepatic cholangiocarcinoma with pancreatitis and transferred to our hospital. DIAGNOSIS: Diagnostic testing (magnetic resonance imaging, endoscopic retrograde cholangiopancreatography, positron emission tomography-computed tomography) revealed a papillary neoplasm and invasive adenocarcinoma with papillary neoplasm in the periampullary lesion. INTERVENTIONS: Pancreaticoduodenectomy, right hemihepatectomy, and left lateral sectionectomy of the liver were performed. After surgery, we planned gemcitabine-based adjuvant chemotherapy. OUTCOMES: Upon completion of the sixth gemcitabine chemotherapy cycle, a hyperechoic, oval-shaped mass (1.3 × 2.6 cm) was found on the outer wall of the right atrium. Resection of a cardiac tumor in the right atrium and patch repair were performed. CONCLUSION: To our knowledge, no other case of cardiac metastasis found during observation after surgery for an IPNB has been described. IPNBs are known to be less aggressive and to have a lower metastasis rate than intraductal papillary mucinous neoplasms; therefore, the number of case reports describing metastasis after surgery is relatively low. Our case suggests that close observation is necessary in patients diagnosed with an IPNB. Lippincott Williams & Wilkins 2021-01-22 /pmc/articles/PMC7837973/ /pubmed/33546060 http://dx.doi.org/10.1097/MD.0000000000024310 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 7100
Lee, Joo Hyung
Kim, Hyung Sun
Park, Ji Hyun
Park, Joon Seong
Intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: A case report
title Intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: A case report
title_full Intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: A case report
title_fullStr Intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: A case report
title_full_unstemmed Intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: A case report
title_short Intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: A case report
title_sort intraductal papillary mucinous neoplasm of the biliary tract with cardiac metastasis: a case report
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837973/
https://www.ncbi.nlm.nih.gov/pubmed/33546060
http://dx.doi.org/10.1097/MD.0000000000024310
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