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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.
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).
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).
Most pancreatic cancers arise in the head next to the bile duct, which is why jaundice is the presenting sign; bile duct cancers are named by where along the tree they sit.
Same organ: Glucagonoma, VIPoma, Somatostatinoma, Pancreatic ductal adenocarcinoma, Biliary tract cancer (cholangiocarcinoma), Intrahepatic cholangiocarcinoma, Extrahepatic cholangiocarcinoma (perihilar and distal), Biliary tract cancer (all types), Neuroendocrine tumours, Pancreatic neuroendocrine tumours, Grade 3 well-differentiated neuroendocrine tumour, Extrapulmonary neuroendocrine carcinoma, Gallbladder cancer, Gallbladder adenocarcinoma, Mucinous carcinoma of the gallbladder, Adenosquamous and squamous carcinoma of the gallbladder, Neuroendocrine carcinoma of the gallbladder, Incidental gallbladder cancer (found after cholecystectomy), Carcinoma in situ and dysplasia of the gallbladder, Cystic duct carcinoma, Ampullary cancer (ampulla of Vater), Resectable pancreatic ductal adenocarcinoma, Borderline resectable pancreatic ductal adenocarcinoma, Locally advanced unresectable pancreatic ductal adenocarcinoma, Metastatic pancreatic ductal adenocarcinoma, KRAS G12C-mutant pancreatic ductal adenocarcinoma, KRAS wild-type pancreatic ductal adenocarcinoma, BRCA or PALB2-mutant pancreatic ductal adenocarcinoma, Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma, Pancreatic acinar cell carcinoma, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatoblastoma, Adenosquamous carcinoma of the pancreas, Colloid (mucinous non-cystic) carcinoma of the pancreas, Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells, Invasive carcinoma arising in an intraductal papillary mucinous neoplasm (IPMN-associated carcinoma), Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma (MCN-associated carcinoma), Solid pseudopapillary neoplasm of the pancreas
Cholecystectomy under the joint European polyp guideline; pathology decides whether invasion is present.
Staged and treated as gallbladder adenocarcinoma by T category.
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Query for this cancer: (TITLE:"Papillary carcinoma of the gallbladder" OR ABSTRACT:"Papillary carcinoma of the gallbladder" OR TITLE:"Papillary adenocarcinoma of the gallbladder" OR ABSTRACT:"Papillary adenocarcinoma of the gallbladder" OR TITLE:"Intracholecystic papillary neoplasm with invasive carcinoma" OR ABSTRACT:"Intracholecystic papillary neoplasm with invasive carcinoma" OR TITLE:"ICPN" OR ABSTRACT:"ICPN") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Papillary carcinoma of the gallbladder, not a curated reading list.
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