Rare Presentation of Intraductal Papillary Neoplasm of the Bile Duct in a Patient With Ulcerative Colitis

A 67-year-old man with insulin-dependent diabetes mellitus and ulcerative colitis presented with worsening pruritus and weight loss. Liver biochemistry showed the following significant cholestatic abnormalities: γ-glutamyltransferase - 1886 IU/mL (<60 IU/mL); alkaline phosphatase - 1201 IU/mL (<110 IU/mL); bilirubin - 66 μmol/L (<24 μmol/L); and near-normal transaminase levels. Magnetic resonant cholangiopancreatogram showed mild proximal dilatation of the extrahepatic bile duct and irregular, abnormally dilated, left-sided biliary radicles.

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