{"entity":{"id":"intracholecystic-papillary-tubular-neoplasm","kind":"term","name":"Intracholecystic papillary-tubular neoplasm (ICPN)","aka":["ICPN","gallbladder adenoma","neoplastic gallbladder polyp","papillary neoplasm of the gallbladder","pyloric gland adenoma of the gallbladder"],"tldr":"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.","asOf":"2026-09-24","links":[{"label":"Adsay et al., Am J Surg Pathol 2012: intracholecystic papillary-tubular neoplasms, 123 cases","url":"https://doi.org/10.1097/pas.0b013e318262787c"},{"label":"Roa et al., J Surg Oncol 2006: preneoplastic lesions in gallbladder cancer","url":"https://doi.org/10.1002/jso.20527"}],"tags":[],"related":[],"cancers":["gallbladder"],"sections":[],"technologies":[],"targets":["ctnnb1"],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["dysplasia","metaplasia-dysplasia-carcinoma-sequence"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-adsay-icpn-gallbladder-ajsp-2012","paper-roa-gallbladder-preneoplastic-lesions-jso-2006"],"journals":[],"dependsOn":[],"notes":[],"category":"Pathology"},"route":"/terms/intracholecystic-papillary-tubular-neoplasm/","neighbours":{"cancer":[{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"}],"target":[{"id":"ctnnb1","kind":"target","name":"CTNNB1","route":"/targets/ctnnb1/"}],"term":[{"id":"dysplasia","kind":"term","name":"Dysplasia (pre-cancerous change)","route":"/terms/dysplasia/"},{"id":"metaplasia-dysplasia-carcinoma-sequence","kind":"term","name":"Metaplasia, dysplasia, carcinoma in situ: the flat route to gallbladder cancer","route":"/terms/metaplasia-dysplasia-carcinoma-sequence/"}],"paper":[{"id":"paper-adsay-icpn-gallbladder-ajsp-2012","kind":"paper","name":"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","route":"/key-papers/paper-adsay-icpn-gallbladder-ajsp-2012/"},{"id":"paper-roa-gallbladder-preneoplastic-lesions-jso-2006","kind":"paper","name":"Preneoplastic lesions in gallbladder cancer","route":"/key-papers/paper-roa-gallbladder-preneoplastic-lesions-jso-2006/"}]}}