Villous adenomas are benign epithelial lesions with malignant potential which can occur at any site in the gastrointestinal tract. They are usually encountered in the rectum and colon, less frequently in the small bowel and very rarely in the biliary trees. Nine cases of bile duct villous adenomas have been reported in the literature. However, 4 cases of bile duct villous adenomas have been reported in the Korean literature. Recently, we experienced a case of villous adenoma in the common hepatic duct in a 77-year-old man presenting with obstructive jaundice in which preoperative histologic diagnosis of villous adenoma played a critical role in managing this patient. Herein, we present a case report of bile duct villous adenoma and a review of the reported cases in Korea to help define and manage this rare disease entity in the bile ducts. In addition, confusing nomenclature of bile duct adenomas is discussed.
Adenoma, Villous/therapy* ; Adenoma, Villous/diagnosis ; Aged ; Bile Duct Neoplasms/therapy* ; Bile Duct Neoplasms/diagnosis ; Case Report ; Cholestasis/etiology ; Human ; Male

A 64-year-old male patient with liver cirrhosis underwent a CT study for hepatocellular carcinoma surveillance, which demonstrated a 1.4-cm hypervascular subcapsular tumor in the liver. On gadoxetic acid-enhanced MRI, the tumor showed brisk arterial enhancement and persistent hyperenhancement in the portal phase, but hypointensity in the hepatobiliary phase. On diffusion-weighted MRI, the tumor showed an apparent diffusion coefficient twofold greater than that of the background liver parenchyma, which suggested that the lesion was benign. The histologic diagnosis was intrahepatic bile duct adenoma with alcoholic liver cirrhosis.
Adenoma, Bile Duct/*diagnosis/etiology ; Bile Duct Neoplasms/*diagnosis/etiology ; *Bile Ducts, Intrahepatic ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging/*methods ; Gadolinium DTPA/diagnostic use ; Humans ; Liver Cirrhosis/*complications/diagnosis ; Male ; Middle Aged