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ABSTRACT: Solitary mixed squamous cell and glandular papilloma of the lung is an extremely rare benign neoplasm. We describe FDG PET/CT findings in a case of solitary mixed squamous cell and glandular papilloma of the lung with high serum carcinoembryonic antigen level (63.3 ng/mL; reference, <5 ng/mL). The tumor showed intense FDG uptake with SUVmax of 23.8 mimicking lung cancer.
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Antígeno Carcinoembrionario , Fluorodesoxiglucosa F18 , Neoplasias Pulmonares , Papiloma , Tomografía Computarizada por Tomografía de Emisión de Positrones , Humanos , Antígeno Carcinoembrionario/sangre , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/patología , Papiloma/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: Narrow-band imaging (NBI) is considered useful for detecting respiratory papillomatosis. However, the choice between preoperative and intraoperative NBI depends on the facility. We investigated the usefulness of NBI and determined whether preoperative NBI can replace intraoperative NBI with a comparable detection rate. METHODS: In this retrospective cohort study conducted at single a tertiary care center, patients with respiratory papillomatosis treated between 2017 and 2022 were enrolled. We systematically compared preoperative white light imaging (WLI) with preoperative and intraoperative NBI. The primary endpoints were the papilloma detection rate and lesion site assessed by the Derkay scoring system. The secondary endpoints were the risk factors for increased Derkay scores. RESULTS: The study included 127 patients with papilloma. Intraoperative NBI yielded significantly higher Derkay scores than preoperative WLI (p < 0.001) and preoperative NBI (p = 0.004). The papilloma detection rates of preoperative WLI and preoperative NBI were not significantly different. Intraoperative NBI detected more lesions than preoperative NBI in 37 of 127 (29%) patients; the overall number of additional lesions was 47 of 279 (17%). Compared with preoperative NBI, intraoperative NBI yielded significantly higher scores for the vocal cords (p = 0.005), false vocal cords (p = 0.010), and ventricle of the larynx (p < 0.001). Elevated Derkay scores were significantly associated with male sex (p = 0.012) and alcohol consumption (p = 0.007). CONCLUSION: Intraoperative NBI is more accurate in detecting papillomatous lesions, and preoperative NBI cannot replace intraoperative NBI. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:1820-1824, 2024.
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Imagen de Banda Estrecha , Papiloma , Infecciones por Papillomavirus , Infecciones del Sistema Respiratorio , Humanos , Masculino , Estudios Retrospectivos , Imagen de Banda Estrecha/métodos , Laringoscopía/métodos , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Sensibilidad y EspecificidadRESUMEN
RATIONALE AND OBJECTIVES: To explore the differential diagnosis of benign and malignant papillary neoplasms on MRI with non-mass enhancement. MATERIALS AND METHODS: A total of 48 patients with surgically confirmed papillary neoplasms showing non-mass enhancement were included. Clinical findings, mammography and MRI features were retrospectively analyzed, and lesions were described according to the breast imaging report and data system (BI-RADS). Multivariate analysis of variance was used to compare the clinical and imaging features of benign and malignant lesions. RESULTS: Fifty-three papillary neoplasms were shown on MR images with non-mass enhancement, including 33 intraductal papilloma and 20 papillary carcinomas (9 intraductal papillary carcinoma, 6 solid papillary carcinomas, and 5 invasive papillary carcinoma). Mammography showed amorphous calcification in 20% (6/30), of which 4 were in papilloma and 2 were in papillary carcinoma. On MRI, papilloma mostly showed linear distribution in 54.55% (18/33), clumped enhancement in 36.36% (12/33). Papillary carcinoma showed segmental distribution in 50% (10/20), clustered ring enhancement in 75% (15/20). ANOVA showed age (p = 0.025), clinical symptoms (p < 0.001), apparent diffusion coefficient (ADC) value (p = 0.026), distribution pattern (p = 0.029) and internal enhancement pattern (p < 0.001) were statistically significant between benign and malignant of papillary neoplasms. Multivariate analysis of variance suggested that the internal enhancement pattern was the only statistically significant factor (p = 0.010). CONCLUSIONS: Papillary carcinoma on MRI with non-mass enhancement mostly showed internal clustered ring enhancement, while papilloma mostly showed internal clumped enhancement; additional mammography is of limited diagnostic value, and suspected calcification occurs mostly in papilloma.
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Neoplasias de la Mama , Carcinoma Intraductal no Infiltrante , Carcinoma Papilar , Papiloma , Humanos , Femenino , Carcinoma Papilar/diagnóstico por imagen , Diagnóstico Diferencial , Estudios Retrospectivos , Neoplasias de la Mama/patología , Imagen por Resonancia Magnética/métodos , Carcinoma Intraductal no Infiltrante/patología , Papiloma/diagnóstico por imagenRESUMEN
Pulmonary papillary tumors are usually occur in the upper respiratory tract, and solitary papilloma in the peripheral lung are extremely rare. Lung papillomas sometimes show the elevation of tumor marker or F18-fluorodeoxyglucose (FDG) uptake, and are difficult to distinguish from lung carcinoma. Here we report a case of mixed squamous cell and glandular papilloma in the peripheral lung. An 85-years-old man without smoking history had been presented with an 8-mm nodule in right lower lobe in chest computed tomographic (CT) 2 years before. Since the diameter of the nodule increased to 12 mm, and positron emission tomography (PET) revealed an abnormally increased FDG uptake in the mass (SUVmax 4.61). StageIA2 lung cancer (cT1bN0M0) was suspected and wedge resection of the lung to make a definitive diagnosis and for treatment was performed. The definite pathological diagnosis was mixed squamous cell and glandular papilloma.
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Neoplasias de los Bronquios , Papiloma , Masculino , Humanos , Anciano de 80 o más Años , Fluorodesoxiglucosa F18 , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Células Epiteliales , PulmónRESUMEN
OBJECTIVE: This study compares the detection rates of haemoglobin absorption spectral imaging and white light imaging in laryngeal papilloma surgery. METHODS: Seventeen patients with laryngeal papilloma who underwent surgery in our department from September 2019 to September 2021 were selected. All patients underwent carbon dioxide laser surgery under a microscope. The lesion sites were explored in white light mode and haemoglobin absorption spectral imaging mode. The pharynx and larynx anatomical sites were evaluated using Derkay's all-position scoring system. The numbers and scores for lesions observed in the two modes were compared. RESULTS: In 17 cases, there were statistically significant differences in the numbers of laryngeal papillomas (Derkay score) detected by white light mode and haemoglobin absorption spectral imaging mode. In 9 of 17 patients (52.94 per cent), the haemoglobin absorption spectral imaging mode showed additional diseased tissues. CONCLUSION: The haemoglobin absorption spectral imaging mode can dynamically identify diseased tissues in carbon dioxide laser surgery under a microscope and improve the laryngeal papilloma detection rate.
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Neoplasias Laríngeas , Laringe , Terapia por Láser , Papiloma , Humanos , Neoplasias Laríngeas/diagnóstico por imagen , Neoplasias Laríngeas/cirugía , Laringe/patología , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Papiloma/patología , Terapia por Láser/métodosRESUMEN
PURPOSE: To describe the anterior segment optical coherence tomography (AS-OCT) appearance of conjunctival papilloma and identify differentiating features from papilliform ocular surface squamous neoplasia (OSSN). METHOD: A retrospective chart review of individuals clinically diagnosed with conjunctival papilloma (n = 10) or papilliform OSSN (n = 10) based on slit lamp features. Data on demographics, tumour characteristics, and primary treatment were collected. AS-OCT features were assessed including epithelial thickness and reflectivity, a corrugated epithelial surface, presence of an overhanging edge, presence of intrinsic spaces and posterior shadowing. Histopathology was available in 5 papilloma and 3 OSSN specimens. RESULT: Overall, the majority of individuals in both groups were white males. OSSN lesions were more likely to involve the limbus (80% vs.10%, p = 0.005) and the bulbar conjunctiva (100% vs. 20%, p < 0.001) compared to papillomas. On AS-OCT, maximum epithelial thickness was thicker in papilloma compared to OSSN (936 ± 533 vs. 637 ± 207 µm, p = 0.009). The feature that best differentiated papilloma from OSSN was an overhanging edge (100% vs. 0%, p < 0.001), where the epithelial lesion was seen on top of underlying normal epithelium. Other features more common in papilloma compared to OSSN included a corrugated epithelial surface (70% vs.10%, p = 0.02), the presence of intrinsic spaces (100% vs. 50%, p = 0.03), and posterior shadowing (100% vs. 40%, p = 0.01). CONCLUSION: AS-OCT shows differentiating features between papilloma and OSSN with an overhanging edge as a distinctive AS-OCT feature of papilloma.
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Carcinoma de Células Escamosas , Neoplasias de la Conjuntiva , Neoplasias del Ojo , Papiloma , Masculino , Humanos , Tomografía de Coherencia Óptica/métodos , Estudios Retrospectivos , Carcinoma de Células Escamosas/diagnóstico por imagen , Neoplasias de la Conjuntiva/diagnóstico por imagen , Neoplasias de la Conjuntiva/patología , Conjuntiva/patología , Papiloma/diagnóstico por imagenRESUMEN
A 76-year-old woman was referred to our hospital due to abnormal chest radiography findings. Chest computed tomography (CT) revealed a nodule in the right lower lobe. Fluorodeoxyglucose-positronemission tomography (FDG-PET) showed abnormal accumulation in the nodule. Bronchoscopy did not provide a definitive diagnosis. Since the nodule tended to increase in size, primary lung cancer was suspected and surgery was performed. During the surgery, pathological diagnosis of squamous cell carcinoma was made, and a right lower lobectomy was performed. Subsequently, a pathological diagnosis of mixed squamous cell and glandular papilloma (mixed papilloma) was made. She has had no sign of recurrence for approximately four years since the surgery.
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Neoplasias Pulmonares , Papiloma , Anciano , Células Epiteliales/patología , Femenino , Fluorodesoxiglucosa F18 , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Tomografía Computarizada por Rayos XRESUMEN
A 76-year-old woman was admitted because of a 25 mm solitary nodule in right S10 on chest computed tomography (CT). 18 fluoro deoxyglucose-positron emission tomography (FDG-PET) indicated accumulation with standardized uptake value( SUV) max 5.2. The serum carcinoembryonic antigen( CEA) and squamous cell carcinoma antigen( SCC) level was elevated. Although the diagnosis was not established by bronchofiberscopy, lung cancer was suspected and the video assisted thoracoscopic surgery (VATS) was carried out. Since no malignant cells were detected by intra-operative pathology, partial resection of the right lower lobe was performed. The postoperative pathological examination revealed features of mixed squamous and glandular papilloma.
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Carcinoma de Células Escamosas , Neoplasias Pulmonares , Papiloma , Anciano , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/cirugía , Femenino , Fluorodesoxiglucosa F18 , Humanos , Pulmón/patología , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Tomografía de Emisión de PositronesAsunto(s)
Tos , Papiloma , Tos/etiología , Disnea/complicaciones , Humanos , Papiloma/complicaciones , Papiloma/diagnóstico por imagenRESUMEN
Narrow-band imaging (NBI) represents a valid aid in laryngeal squamous cell carcinoma (LSCC) diagnosis for detecting vascular changes. However, LSCC and laryngeal papillomatosis (LP) show similar vascular patterns that may lead to misdiagnosis and improper treatment. This review aims to deepen this NBI limit in order to stress a careful preoperative evaluation of laryngeal lesions. The research was carried out on PubMed, Web of Science and Scopus databases using specific keywords. The topic of research was assessed by these parameters: accuracy, sensitivity, specificity, and positive and negative predictive values. This review included only five articles: they demonstrated that NBI is better than white-light endoscopy in detecting LSCC and LP. They also reported that LP is frequently mistaken for LSCC, resulting in high rates of false positives using NBI. This is the first review that emphasized this NBI limitation in distinguishing between LP and LSCC in cases of a type V pattern of intraepithelial papillary capillary loop. Although NBI application increased the rate of early cancer detection, LP reduces NBI accuracy. This drawback may lead to misdiagnosis and improper treatment. Our advice is to be careful in cases of type V pattern on NBI and to research LP epithelial and clinical features because it could be a pitfall.
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Neoplasias Laríngeas , Papiloma , Humanos , Neoplasias Laríngeas/diagnóstico por imagen , Laringoscopía/métodos , Imagen de Banda Estrecha/métodos , Papiloma/diagnóstico por imagen , Papiloma/patología , Sensibilidad y EspecificidadRESUMEN
We report the case of a 78-year-old woman with dyspepsia for several years and a history of cholecystectomy, informed by pathology as calculous cholecystopathy, where CT revealed a left-sided intrahepatic bile duct dilation. Cholangio-MRI confirmed a size increase in the distal intrahepatic bile duct on the left side, with T2-hyperintense contents with scarce contrast enhancement, which resulted in the observed dilation. . A Spybite® forceps was used to obtain a biopsy sample, which showed a benign papillary growth compatible with biliary papillomatosis. Biliary papillomatosis or intraductal papillary neoplasm of the biliary tract is a rare, uncommon condition characterized by intraductal papillary growth of the biliary epithelium. It has a tendency towards malignization, hence must be considered a premalignant condition . Major symptoms include jaundice, abdominal pain, and repeat cholangitis, with imaging studies being key for diagnostic suspicion . The development of cholangioscopy with biopsies allows an early diagnosis of malignant precursor lesions of the bile duct, thus allowing early treatment.
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Neoplasias de los Conductos Biliares , Procedimientos Quirúrgicos del Sistema Biliar , Colangiocarcinoma , Papiloma , Anciano , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Neoplasias de los Conductos Biliares/cirugía , Conductos Biliares Intrahepáticos/diagnóstico por imagen , Conductos Biliares Intrahepáticos/patología , Colangiocarcinoma/diagnóstico por imagen , Colangiocarcinoma/cirugía , Dilatación Patológica , Femenino , Humanos , Papiloma/diagnóstico por imagen , Papiloma/cirugíaAsunto(s)
Papiloma , Humanos , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Estudios RetrospectivosAsunto(s)
Neoplasias Esofágicas , Papiloma , Neoplasias Esofágicas/complicaciones , Neoplasias Esofágicas/diagnóstico por imagen , Neoplasias Esofágicas/patología , Fluorodesoxiglucosa F18 , Humanos , Estadificación de Neoplasias , Papiloma/complicaciones , Papiloma/diagnóstico por imagen , Tomografía de Emisión de Positrones , RadiofármacosRESUMEN
Objective:To analysze the clinical and imaging features of sinonasal oncocytic papillomaï¼SNOPï¼. Methods:The clinical data of 31 cases of SNOP confirmed by pathology from May 2006 to September 2020 were retrospectively analyzed. The common sites of the tumor, clinical symptoms, imaging features and follow-up results were analyzed. Results:Among the 31 patients, the common clinical symptoms were nasalobstructionand running nose. All the lesions were unilateral. The origin of the tumors was maxillary sinus in 17 cases, ethmoid sinus in 7 cases, frontal sinus in 4 cases, and sphenoid sinus in 3 cases. CT findings: 12 casesï¼38.7%ï¼ had hyperosteogeny or destruction, of which 3 casesï¼9.7%ï¼ showed focal osteitis. MRI findings: 25 casesï¼92.6%ï¼ showed "cerebriform" sign on T2WI or enhanced T1WI; 19 patientsï¼70.4%ï¼ showed high or isointense signal on T1WI; 17 casesï¼63.0%ï¼ were associated with multiple cystoid changes. All patients were pathologically confirmed as SNOP, including 1 case with focal moderate to severe dysplasia and 1 case with carcinogenesis in situ. With follow-up 5 to 177 months, 1 case recurred, and the recurrence rate was 3.2%. Conclusion:The clinical symptoms of SNOP lack specificity and could be accompanied by polyps. The maxillary sinuses are most often involved, but other sinuses may also be affected. Nasal endoscopy and imaging examination have certain characteristics. The root pedicle of the tumor was mostly broad-based, with certain recurrence rate and malignant degeneration. Therefore, a reasonable surgical method should be selected to completely resect the lesion and reduce the recurrence.
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Papiloma Invertido , Papiloma , Neoplasias de los Senos Paranasales , Endoscopía , Senos Etmoidales , Humanos , Imagen por Resonancia Magnética , Seno Maxilar , Recurrencia Local de Neoplasia , Papiloma/diagnóstico por imagen , Papiloma Invertido/diagnóstico por imagen , Neoplasias de los Senos Paranasales/diagnóstico por imagen , Estudios RetrospectivosRESUMEN
Sinonasal papilloma (SP), formerly Schneiderian papilloma, represents a rare group of benign epithelial neoplasms, most commonly identified in the sinonasal tract, while less frequently identified in the pharynx, lacrimal sac, and middle ear. Within temporal bone sinonasal-type papilloma (TBSP), there seems to be a much higher recurrence and malignant transformation risk than those identified in the sinonasal tract. Based on this clinical report and a review of the cases reported in the English literature, 49% of the 57 cases developed in the setting of concurrent or antecedent sinonasal or nasopharyngeal SP. There is an equal sex distribution (26 females and 31 males), with a broad age range (19-81 years) at presentation (median 56 years; average 54 years). Three patients had bilateral disease. Symptoms include a mass lesion with hearing loss, otitis media, otorrhea, otalgia, and tinnitus, among others. Inverted SP was identified in 42 patients, oncocytic SP in six, and exophytic SP in four (undefined in the remainder). Recurrence was identified in 38 of 49 patients with follow-up (78%), often with multiple recurrences over time, with carcinoma developing in the temporal bone in 19 patients (33%), with males developing carcinoma by a 1.7:1 ratio over females. Surgery was the treatment of choice (radical mastoidectomy) with 6 patients (10%) dead of disease (median 30 months, mean 38 months), while 47 patients were alive at last follow-up: 31 without disease (mean 33 months); 7 with locally recurrent disease (mean 20 months); 9 patients alive but with unknown disease status; and 4 patients without follow-up. In conclusion, TBSP is frequently identified in the setting of concurrent sinonasal tract disease, showing similar histologic features to sinonasal tract counterparts. There is no sex predilection, with patients most commonly presenting in the sixth decade of life. Recurrences are common, with carcinoma developing much more frequently than in sinonasal tract papilloma (33%), but recognizing that carcinoma may be documented in either or both anatomic sites. Overall outcome is excellent, with long term clinical follow-up warranted to manage recurrence or malignant transformation.
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Neoplasias del Oído/patología , Papiloma/patología , Neoplasias Craneales/patología , Hueso Temporal/patología , Neoplasias del Oído/diagnóstico por imagen , Neoplasias del Oído/cirugía , Oído Medio/diagnóstico por imagen , Oído Medio/cirugía , Dolor de Oído/etiología , Pérdida Auditiva/etiología , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Otitis Media/etiología , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Neoplasias Craneales/diagnóstico por imagen , Neoplasias Craneales/cirugía , Hueso Temporal/diagnóstico por imagen , Hueso Temporal/cirugía , Acúfeno/etiologíaRESUMEN
BACKGROUND. Despite numerous published studies, management of benign papillomas without atypia remains controversial. OBJECTIVE. The purpose of this study was to determine the malignancy upgrade rate of benign papillomas, identify risk factors for upgrade, and formulate criteria for selective surgery. METHODS. This retrospective study included benign papillomas without atypia diagnosed on percutaneous biopsy between December 1, 2000, and December 31, 2019. Papillomas that did not undergo surgical excision or at least 2 years of imaging and/or clinical follow-up were excluded. Clinical, imaging, and histopathologic features were extracted from the electronic medical record. Features associated with upgrade to malignancy were identified. Multivariable logistic regression was performed. RESULTS. The study included 612 benign papillomas in 543 women (mean age, 54.5 ± 12.1 [SD] years); 466 papillomas were excised, and 146 underwent imaging or clinical surveillance. The upgrade rate to malignancy was 2.3% (14/612). Upgrade rate was associated (p < .05) with radiology-pathology correlation (50.0% if discordant vs 2.1% if concordant), patient age (5.6% for 60 years and older vs 0.7% for younger than 60 years), presenting symptoms (6.7% if palpable mass or pathologic nipple discharge vs 1.3% if no symptoms), and lesion size (7.3% if ≥ 10 mm vs 0.6% if < 10 mm). Three of 14 upgraded papillomas were associated with four or more metachronous or concurrent peripheral papillomas. No incidental papilloma or papilloma reported as completely excised on core biopsy histopathologic analysis was upgraded. A predictive model combining radiology-pathology discordance, symptoms (palpable mass or nipple discharge), age 60 years old and older, size 10 mm or larger, and presence of four or more metachronous or concurrent peripheral papillomas achieved an AUC of 0.91, sensitivity of 79%, and spec-ificity of 89% for upgrade. Selective surgery based on presence of any of these five factors, although excluding from surgery incidental papillomas and papillomas reported as completely excised on histopathology, would have spared 294 of 612 lesions from routine excision and identified all 14 upgraded lesions. CONCLUSION. Benign nonatypical papillomas have a low malignancy upgrade rate; routine surgical excision may not be necessary. Selective excision is recommended for lesions satisfying any of the five criteria. Incidental papillomas or papillomas completely excised on histopathology may undergo imaging follow-up. CLINICAL IMPACT. The proposed criteria for selective surgery of benign papillomas on core biopsy would reduce surgeries without delaying diagnosis of malignancy.
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Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Papiloma/diagnóstico por imagen , Papiloma/patología , Ultrasonografía Mamaria/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja Gruesa , Neoplasias de la Mama/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Biopsia Guiada por Imagen , Persona de Mediana Edad , Papiloma/cirugía , Estudios Retrospectivos , Adulto JovenRESUMEN
Most maxillary sinus papillomas are confirmed when they have extended beyond the nasal cavity and are rarely found while localized in the maxillary sinus. We experienced two cases of localized papilloma in the maxillary sinus. Case 1 was a 69-year-old man with a localized left maxillary sinus lesion detected during a routine imaging examination. As the lesion was likely to be papilloma, we recommended that the patient undergo diagnostic surgery, which he refused. He experienced bloody rhinorrhea 1 year and 9 months after the first visit, and computed tomography (CT) showed increased lesions and bone destruction. Histological examinations revealed squamous cell carcinoma ex inverted papilloma. He died 5 years after the first visit. Case 2 was a 46-year-old woman in whom positron emission tomography/CT showed a localized right maxillary sinus lesion. Tissue biopsy results indicated oncocytic papilloma. Endoscopic resection was performed later. On an imaging examination, sinonasal papilloma was determined accidentally to be a localized lesion of the maxillary sinus. A detailed interpretation of the CT scan was useful in estimating sinonasal papilloma. Tissue biopsy or diagnostic surgery should be performed when sinonasal papilloma is suspected during appropriate image evaluation.
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Hallazgos Incidentales , Neoplasias del Seno Maxilar/diagnóstico por imagen , Neoplasias del Seno Maxilar/cirugía , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Anciano , Biopsia , Carcinoma de Células Escamosas/patología , Transformación Celular Neoplásica/patología , Resultado Fatal , Femenino , Humanos , Masculino , Neoplasias del Seno Maxilar/patología , Persona de Mediana Edad , Papiloma/patología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Negativa del Paciente al TratamientoRESUMEN
BACKGROUND: Biliary papillomatosis is a rare type of papillomatosis. Depending on the location of the disease, radical surgical resection or liver transplants are the treatment of choice. These radical surgical options may be unrealistic in patients who are not surgical candidates or who are unwilling to consider surgery. AIMS: To evaluate the effectiveness of endoscopic electrocoagulation for the biliary papillomatosis. METHODS: In this case series, we report six patients with unresectable biliary papillomatosis who underwent cholangioscopic electrocoagulation using needle knife and their clinic follow up information. RESULTS: After patients received cholangioscopy with electrocoagulation of the residual biliary papilloma, the daily T-tube drainage volume increased to 200-400ml with improvement in the drainage content and significant relief of clinical symptoms, such as jaundice and abdominal pain. CONCLUSION: This method of using electrocoagulation to directly target and destroy tumor tissue is a safe and effective alternative for those with unresectable disease, and this method has shown to enhance T-tube drainage volume and improve patients' overall clinical symptoms.