# Intracholecystic papillary-tubular neoplasm (ICPN)

Source: https://onco.cc/terms/intracholecystic-papillary-tubular-neoplasm/  
OnCo record `intracholecystic-papillary-tubular-neoplasm` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

An ICPN is a raised, polyp-like growth of the gallbladder lining 1 cm or larger that can turn into cancer. It is the rarer route to gallbladder cancer, and the cancers that arise from it do better than those from flat dysplasia.

## Summary

Adsay and colleagues grouped neoplastic polyps, adenomas and papillary neoplasms of the gallbladder measuring 1 cm or more under one heading, intracholecystic papillary-tubular neoplasm, in a 123-case series: female to male 2 to 1, mean age 61, median size 2.2 cm, gallstones in only 20%, and growth patterns papillary (43%), tubulopapillary (31%) or tubular (26%) with biliary (50%), gastric foveolar (16%), gastric pyloric (20%), intestinal (8%) and oncocytic (6%) lineages. Invasive carcinoma accompanied 55% of cases, and even lesions that would have been called pyloric gland adenomas had high-grade dysplasia in 88% and invasion in 18%. Three-year survival was 90% without invasion and 60% with it, against 27% for ordinary pancreatobiliary-type gallbladder carcinoma, an advantage that held after stage matching; among systematically analysed invasive carcinomas only 6.4% had a tumoral precursor, confirming that this is the minority route (Adsay 2012; Roa 2006 put adenomas at 0.14% of cholecystectomies). CTNNB1 mutation with aberrant beta-catenin expression has been described in incipient ICPNs. Because half present incidentally and radiology labels almost half as cancer, the practical consequence is that polyps of 1 cm or more are removed.

## Fields

- Kind: Term
- Last checked: 2026-09-24
- Also known as: ICPN; gallbladder adenoma; neoplastic gallbladder polyp; papillary neoplasm of the gallbladder; pyloric gland adenoma of the gallbladder

## Sources

- Adsay et al., Am J Surg Pathol 2012: intracholecystic papillary-tubular neoplasms, 123 cases: https://doi.org/10.1097/pas.0b013e318262787c
- Roa et al., J Surg Oncol 2006: preneoplastic lesions in gallbladder cancer: https://doi.org/10.1002/jso.20527

## Connected records

- cancers: [Gallbladder cancer](https://onco.cc/cancers/gallbladder/)
- targets: [CTNNB1](https://onco.cc/targets/ctnnb1/)
- terms: [Dysplasia (pre-cancerous change)](https://onco.cc/terms/dysplasia/), [Metaplasia, dysplasia, carcinoma in situ: the flat route to gallbladder cancer](https://onco.cc/terms/metaplasia-dysplasia-carcinoma-sequence/)
- key papers: [Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are at least 1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases](https://onco.cc/key-papers/paper-adsay-icpn-gallbladder-ajsp-2012/), [Preneoplastic lesions in gallbladder cancer](https://onco.cc/key-papers/paper-roa-gallbladder-preneoplastic-lesions-jso-2006/)

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