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Clinicopathologic review of 58 patients with biliary papillomatosis
Author(s) -
Lee Sang Soo,
Kim MyungHwan,
Lee Sung Koo,
Jang Se Jin,
Song MoonHee,
Kim KyuPyo,
Kim Hong Ja,
Seo DongWan,
Song Dong Eun,
Yu Eunsil,
Lee SeungGyu,
Min Young Il
Publication year - 2004
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20031
Subject(s) - medicine , asymptomatic , gastroenterology , jaundice , papillomatosis , medical record , malignancy , adenocarcinoma , pathology , cancer
BACKGROUND Biliary papillomatosis (BP) is a rare disease that is characterized by multiple numerous papillary adenomas in the biliary tree. The clinical features and outcome, however, are not well known. The authors retrospectively analyzed their clinicopathologic features and long‐term follow‐up results. METHODS Between March 1995 and January 2003, 58 patients were diagnosed with BP by cholangioscopic and histologic findings at a tertiary referral center, Asan Medical Center (University of Ulsan College of Medicine, Seoul, Korea). The authors retrospectively reviewed the medical records to obtain demographic, radiologic, cholangioscopic, and pathologic data. RESULTS The common clinical manifestations at the presentation of patients were repeated episodes of abdominal pain, jaundice, and acute cholangitis. Acute cholangitis was more common in patients with mucin‐hypersecreting BP (MBP), whereas patients with nonmucin‐producing BP (NMBP) were more asymptomatic ( P < 0.05). Papillary adenocarcinoma and mucinous carcinoma were detected in 48 patients (83%) with papillary adenomas. Overall survival rates of NMBP and MBP were 89% and 69% at 1 year, 57% and 37% at 3 years, and 52% and 19% at 5 years, respectively. The mean survival period of NMBP and MBP was 52.27 ± 6.72 months and 30.84 ± 8.36 months, respectively. CONCLUSIONS BP should be regarded as a premalignant disease with high malignant potential. The pathogenesis of progression from benign to malignant disease may follow the adenomacarcinoma sequence. Although clinical presentations were somewhat different for patients with NMBP and MBP, the long‐term survival rate was similar. Cancer 2004;100:783–93. © 2004 American Cancer Society.