# Papillary carcinoma of the gallbladder

Source: https://onco.cc/cancers/gallbladder-papillary-carcinoma/  
OnCo record `gallbladder-papillary-carcinoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Papillary carcinoma is a gallbladder cancer that grows as finger-like fronds into the cavity rather than burrowing into the wall. Cancer Research UK notes it is less likely to spread to the liver and lymph nodes and tends to have a better outlook. Its polypoid precursor, the intracholecystic papillary neoplasm, is often removed before it invades.

## Summary

Papillary (exophytic) growth in the gallbladder covers two related entities that the WHO classification (5th edition, 2019) separates. The intracholecystic papillary (or papillary-tubular) neoplasm, ICPN, is a mass-forming preinvasive neoplasm of 1 cm or more: in the defining series of 123 cases patients were mostly women (2 to 1), mean age 61, median size 2.2 cm, half presenting with pain and half found incidentally, and gallstones were present in only 20 percent, far below their frequency in ordinary gallbladder cancer (Adsay 2012). Papillary gallbladder carcinoma proper is an invasive adenocarcinoma with complex papillary architecture. Akita and colleagues, applying strict criteria to 75 cancers, found that ICPNs (7) showed gross mucin hypersecretion in 43 percent, had no lymphovascular invasion or nodal metastasis, and were less advanced than either papillary (24) or non-papillary (44) carcinomas, in which those features occurred in 13 to 59 percent; exome sequencing also separated the groups (Akita 2019). Cancer Research UK describes papillary adenocarcinoma as less likely to spread to the liver and nearby nodes and as having a better outlook than most other types.

What differs in treatment: the polypoid growth means these lesions are often visible on ultrasound and removed as polyps of 10 mm or more under the European polyp guideline, sometimes while still preinvasive; once invasive they are staged and treated as adenocarcinoma. A papillary lesion can be difficult to tell from adenomyomatosis or a cholesterol polyp on imaging, and the pathology report should say whether invasion is present and how deep (Adsay 2012; Foley 2022).

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Papillary adenocarcinoma of the gallbladder; Intracholecystic papillary neoplasm with invasive carcinoma; ICPN
- Tags: gallbladder; biliary; subtype-page
- Group: gastrointestinal
- Burden: A minority of gallbladder adenocarcinomas; in one Japanese pathology series 24 of 75 gallbladder cancers were papillary by strict criteria and 7 were intracholecystic papillary neoplasms (Akita 2019).
- Subtypes: Intracholecystic papillary neoplasm of the gallbladder without invasion (preinvasive); Intracholecystic papillary neoplasm with associated invasive carcinoma; Papillary adenocarcinoma of the gallbladder (invasive, complex papillary architecture)
- Biomarkers: Presence and depth of invasion in a papillary lesion; Gross mucin hypersecretion (a feature of ICPN); Lymphovascular invasion and nodal status; Polyp size on ultrasound (10 mm threshold for cholecystectomy)

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/gallbladder-papillary-carcinoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/gallbladder-papillary-carcinoma/#overview
- Types and stages (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/gallbladder-papillary-carcinoma/#what-it-is [3 subtypes]
- Symptoms and diagnosis (on the hub): How this cancer shows itself, how the diagnosis is confirmed, and the biomarkers clinicians test for. https://onco.cc/cancers/gallbladder-papillary-carcinoma/#finding-it [4 biomarkers]
- Treatment (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/gallbladder-papillary-carcinoma/#treating-it [2 settings]
- Trials and papers (on the hub): Trials recruiting now, the landmark trials, the trials held by this cancer's subtypes, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/gallbladder-papillary-carcinoma/#evidence
- Biology and targets (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/gallbladder-papillary-carcinoma/#science
- Countries and centres (own page): Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes. https://onco.cc/cancers/gallbladder-papillary-carcinoma/where-you-are/
- Decisions and support (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/gallbladder-papillary-carcinoma/#living-with-it [8 questions, 1 decision aid]
- Pipeline and open problems (own page): Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/gallbladder-papillary-carcinoma/coming/
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/gallbladder-papillary-carcinoma/data/ [4 connected records]

## Standard of care

- Polypoid lesion of 10 mm or more on ultrasound: Cholecystectomy under the joint European polyp guideline; pathology decides whether invasion is present. ([Gallbladder polyp (polypoid lesion)](https://onco.cc/terms/gallbladder-polyp/), [Simple cholecystectomy](https://onco.cc/terms/simple-cholecystectomy/))
- Invasive papillary carcinoma: Staged and treated as gallbladder adenocarcinoma by T category. ([Gallbladder adenocarcinoma](https://onco.cc/cancers/gallbladder-adenocarcinoma/), [Radical (extended) cholecystectomy](https://onco.cc/terms/radical-cholecystectomy/))

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Gallbladder_cancer
- CRUK: types of gallbladder cancer: https://www.cancerresearchuk.org/about-cancer/gallbladder-cancer/types
- Adsay, Am J Surg Pathol 2012: intracholecystic papillary-tubular neoplasms, 123 cases: https://doi.org/10.1097/pas.0b013e318262787c
- Akita, Am J Surg Pathol 2019: intracholecystic papillary neoplasms are distinct from papillary gallbladder cancers: https://doi.org/10.1097/pas.0000000000001237
- ESGAR, EAES, EFISDS and ESGE joint guideline on gallbladder polyps (Foley, Eur Radiol 2022): https://doi.org/10.1007/s00330-021-08384-w
- Nagtegaal, Histopathology 2020: the 2019 WHO classification of tumours of the digestive system: https://doi.org/10.1111/his.13975

## Connected records

- cancers: [Carcinoma in situ and dysplasia of the gallbladder](https://onco.cc/cancers/gallbladder-carcinoma-in-situ-and-dysplasia/), [Gallbladder adenocarcinoma](https://onco.cc/cancers/gallbladder-adenocarcinoma/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Mucinous carcinoma of the gallbladder](https://onco.cc/cancers/gallbladder-mucinous-carcinoma/)
- terms: [Carcinoma in situ (CIS)](https://onco.cc/terms/carcinoma-in-situ/), [Gallbladder polyp (polypoid lesion)](https://onco.cc/terms/gallbladder-polyp/), [Radical (extended) cholecystectomy](https://onco.cc/terms/radical-cholecystectomy/), [Simple cholecystectomy](https://onco.cc/terms/simple-cholecystectomy/)

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JSON: https://onco.cc/api/v1/entities/gallbladder-papillary-carcinoma.json