Intracholecystic Papillary Neoplasm: A Rare Differential of Carcinoma Gallbladder

Intracholecystic papillary neoplasm (ICPN) is a relatively new disease entity with an incidence of 0.40 to 0.61% in all cholecystectomies. It is a rare non-invasive, premalignant entity. We are presenting one such rare case of ICPN in a mid-70 s gentleman who presented to the surgery outpatient department with complaints of abdominal pain in the right upper quadrant. The radiological imaging was highly suggestive of carcinoma gallbladder localized to the fundus, and the patient underwent open radical cholecystectomy. To our surprise, the histopathological examination was suggestive of intracholecystic papillary neoplasm. We have highlighted ICPN as the differential of carcinoma gallbladder and its importance in clinical practice and the fact that nearly 60% of patients with ICPN die of biliary tract cancer, typically long after the diagnosis of ICPN. This suggests that a field effect renders the remainder of the biliary tract at risk of carcinoma.