Projects

Biliary intraductal papillary mucinous tumor is a rare neoplasm that has been described with increasing frequency over the past 15 years.l-4 It is usually a malignant papillary tumor that secretes large amounts of mucus with resultant bile duct dilation and obstruction. Presenting manifestations include jaundice, abdominal pain, and/or cholangitis. With a 5-year survival of 31% in the largest series reported to date, the prognosis for patients with biliary intraductal papillary mucinous tumor is better than for those with cholangiocarcinoma.5, 6 ERCP often fails to diagnose and localize the tumor because of filling of the dilated biliary tree with thick mucus.4,5,7, s Therefore, diagnosis and localization are most commonly by percutaneous and intraoperative cholangioscopy.4-6,8, 9 Direct endoscopic visualization of a biliary intraductal papillary mucinous tumor with a forward-viewing pediatric upper endoscope in a patient with a prior gastrectomy and Billroth II anastomosis was reported over 10 years ago. 10 A case is described here of biliary intraductal papillary mucinous tumor accurately diagnosed and localized before surgery with endoscopic retrograde cholangioscopy.