%0 Journal Article
%T Simultaneous intraductal papillary neoplasms of the bile duct and pancreas treated with chemoradiotherapy
%A Roberto Valente
%A Gabriele Capurso
%A Paola Pierantognetti
%A Elsa Iannicelli
%J World Journal of Gastrointestinal Oncology
%D 2012
%I Baishideng Publishing Group Co. Limited
%R 10.4251/wjgo.v4.i2.22
%X Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct (IPMN-B) could be the the biliary counterpart of IPMN of the pancreas (IPMN-P) since they share several clinical-pathological features. These include prominent intraductal papillary proliferation pattern, a gastrointestinal phenotype, frequent mucin hyper-secretion and progression to mucinous carcinoma. To date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated surgically. We hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky fluid lesion obstructing the bile duct lumen, diagnosed as a malignant IPMN-B, and synchronous multiple pancreatic cystic lesions (10-13 mm) communicating with an irregular Wirsung, diagnosed as branch duct IPMN-P. Since surgery was ruled-out because of the patient¡¯s age and preferences, she underwent a conservative management regimen comprising both chemotherapy and radiotherapy. This was effective in decreasing the mass size and in resolving subsequent jaundice. This is also the first reported case of IPMN-B successfully treated with chemoradiotherapy. Clinicians should consider medical treatment as an option in this clinical scenario, in patients who may be unfit for surgery.
%K Intraductal papillary neoplasm
%K Bile duct
%K Simultaneous
%K Pancreatic intraductal papillary mucinous neoplasm
%U http://www.wjgnet.com/1948-5204/full/v4/i2/22.htm