He XX, Feng YL, Zhang ZW, Xu TM, Li JN. Synchronous intracholecystic papillary-tubular neoplasm and pancreatic intraductal tubulopapillary neoplasm: A case report. World J Gastrointest Oncol 2026; 18(10): 123534 [DOI: 10.4251/wjgo.123534]
Corresponding Author of This Article
Tian-Ming Xu, MD, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Dongsheng District, Beijing 100730, China. xutianming@pumch.cn
Research Domain of This Article
Gastroenterology & Hepatology
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case-report
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World J Gastrointest Oncol. Oct 15, 2026; 18(10): 123534 Published online Oct 15, 2026. doi: 10.4251/wjgo.123534
Synchronous intracholecystic papillary-tubular neoplasm and pancreatic intraductal tubulopapillary neoplasm: A case report
Xu-Xia He, Yun-Lu Feng, Zhi-Wen Zhang, Tian-Ming Xu, Jing-Nan Li
Xu-Xia He, Yun-Lu Feng, Tian-Ming Xu, Jing-Nan Li, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Xu-Xia He, Tian-Ming Xu, Jing-Nan Li, Key Laboratory of Gut Microbiota Translational Medicine Research, Chinese Academy of Medical Sciences, Beijing 100730, China
Zhi-Wen Zhang, Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
Co-corresponding authors: Tian-Ming Xu and Jing-Nan Li.
Author contributions: He XX, Feng YL, Xu TM, and Li JN did the study concept and design; He XX, Xu TM, and Li JN performed data analysis and interpretation; He XX contributed to drafting of the manuscript; Feng YL supervised the study; Zhang ZW contributed to analysis and interpretation of the pathological data; Xu TM and Li JN supervised the study and they contributed equally to this manuscript as co-corresponding authors. All authors approved the final version of this manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools (DeepSeek-V3) solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by the National Key R&D Program of China, No. 2025YFC3408700 and No. 2025YFC3408701.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Tian-Ming Xu, MD, Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Dongsheng District, Beijing 100730, China. xutianming@pumch.cn
Received: May 21, 2026 Revised: June 17, 2026 Accepted: July 3, 2026 Published online: October 15, 2026 Processing time: 123 Days and 0.3 Hours
Abstract
BACKGROUND
Intracholecystic papillary-tubular neoplasm (ICPN) and intraductal tubulopapillary neoplasm (ITPN) are grossly and radiologically visible intraductal neoplasms of the pancreatobiliary tract. Although these entities share several clinicopathological features, synchronous gallbladder ICPN and pancreatic ITPN have rarely been described and may provide insight into multifocal pancreatobiliary tumorigenesis.
CASE SUMMARY
A 30-year-old woman presented with a one-month history of intermittent right upper abdominal pain, particularly after fatty meals. Contrast-enhanced computed tomography and magnetic resonance imaging revealed a giant gallbladder with multiple intraluminal protrusions and multiple cystic-solid pancreatic lesions extending from the pancreatic head to the tail, with the largest measuring approximately 3.0 cm. Positron emission tomography/computed tomography showed increased fluorodeoxyglucose uptake in both the gallbladder and pancreatic lesions. Endoscopic ultrasound-guided fine-needle aspiration yielded only scant atypically proliferating glandular epithelial cells. Given the patient’s young age, multifocal pancreatobiliary involvement, and high radiologic suspicion for malignancy, total pancreatectomy with extended cholecystectomy and lymph node dissection was performed. Histopathological examination confirmed gallbladder ICPN with high-grade dysplasia and pancreatic ITPN with multifocal invasive carcinoma confined within the pancreas. Germline whole-exome sequencing did not identify a pathogenic variant. Postoperatively, the patient received endocrine follow-up and long-term oncologic surveillance.
CONCLUSION
This case expands the clinicopathological spectrum of pancreatobiliary intraductal neoplasia. Together with the literature review, it raises the possibility of a field effect or shared epithelial susceptibility when multifocal intraductal lesions arise across the gallbladder and pancreas. The case also highlights the need for long-term surveillance of the residual pancreatobiliary tract after surgical treatment.
Core Tip: Intracholecystic papillary-tubular neoplasm and pancreatic intraductal tubulopapillary neoplasm are usually discussed as related but separate intraductal neoplasms. We report a 30-year-old woman with synchronous multifocal cystic-solid lesions involving the gallbladder and the pancreas. Surgical pathology showed gallbladder intracholecystic papillary-tubular neoplasm with high-grade dysplasia and pancreatic intraductal tubulopapillary neoplasm with multifocal invasive carcinoma. Unlike most reported pancreatic-gallbladder double tumors, this case showed no evident pancreaticobiliary maljunction and involved two intraductal neoplasms. These findings suggest a possible field effect or shared epithelial susceptibility rather than simple reflux-related carcinogenesis, although this hypothesis remains unproven without somatic sequencing or clonality studies.
