Joint Hospital Surgical Grand Round . 18 th April 2009. Biliary Papillomatosis: unrecognised preoperative diagnosis. Law, SY F/ 68 HT & DM on medications Open cholecystectomy (symptomatic gallstone) for 10 years ago CBD stones with ERCP for removal in 2004. c/o mild RUQ pain in OPD FU
18th April 2009
BP was considered in the past to be a disease with low malignant potential.
as BP with high-grade atypia
as BP with in situ carcinoma
as BP with microscopic foci of stromal invasion
BP with definite invasion into the hepatic parenchyma or fibromuscular layer of the bile duct wall
might be similar to bile duct stones.
cystadenoma, cystadenicarcinoma and liver abscess.
malignant transformation may not be properly excluded in the ‘benign’ cases reported in the literature.
prolonged follow-up may allow detection of malignant transformation. Progression from epithelial dysplasia to carcinoma in situ and to frank invasive adenocarcinoma has been suggested
chronic biliary irritation or injury may play a contributory role.