J Korean Soc Radiol.  2012 Aug;67(2):113-116. 10.3348/jksr.2012.67.2.113.

Unexpected Metastasis of Intraductal Papillary Mucinous Neoplasm of the Bile Duct into Thoracic Cavity with Direct Extension: Case Report

Affiliations
  • 1Department of Radiology, Hanyang University Guri Hospital, Guri, Korea. radjena@hanyang.ac.kr
  • 2Department of Radiology, Hanyang University Seoul Hospital, Seoul, Korea.

Abstract

Intraductal papillary mucinous neoplasm (IPMN) is known to arise from intraductal proliferation of mucinous cells with findings of marked dilatation of the biliary or pancreatic duct. There are reports of the metastasis and extension of pancreatic IPMN. However, cases of biliary IPMN with direct metastasis, or metastasis to distant locations, are rare. We present a case of metastasis of biliary IPMN with unexpected direct extension into the thoracic cavity, and we attempt to account for the mechanism of this extension.


MeSH Terms

Bile
Bile Ducts
Dilatation
Mucins
Neoplasm Metastasis
Pancreatic Ducts
Thoracic Cavity
Mucins

Figure

  • Fig. 1 The 82-year-old female with biliary intraductal mucinous papilloma with direct extension into the left thoracic cavity. A. Axial CT image shows markedly disproportionally dilatated left intrahepatic duct (arrow) without intramural nodule. B. Coronal CT image reveals the markedly disproportionally dilatated left intrahepatic duct (arrow) without intramural nodule. C. Coronal CT image of the posterior of (B) shows extension to the diaphragm of the dilated bile duct (arrow), the resultant of communication with the left thoracic space leading to empyema (arrowhead). D. Percutaneous transhepatic cholangiography shows disproportionally dilated left intrahepatic duct (arrow) and communication with the left thoracic space (arrowheads).


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