We report a case of a rare congenital anomaly, a double-orifice mitral valve, in a 19-year-old man who was admitted because of chest discomfort. Physical examination revealed no significant findings, but transthoracic echocardiography revealed 2 functional orifices of approximately equal size in the mitral valve. Color Doppler flow imaging revealed that mitral flow was normal and without regurgitation or stenosis. No other associated congenital abnormality was observed. We followed up the patient conservatively without surgical repair because both left ventricular function and mitral flow were normal. Although this patient did not require any treatment, he should be carefully followed up to find possible future pathological conditions, such as a flail leaflet causing mitral regurgitation. (Jikeikai Med J 2016 ; 63 : 27-30)
Intraductal papillary neoplasm of the bile duct (IPNB) is a rare tumor that is characterized by papillary growth into the bile duct lumen and is considered as a biliary counterpart of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. However, the definition of IPNB remains controversial because its malignant potential is higher and its frequency of mucus production is lower than those of IPMN. Herein, we report 3 cases of IPNB resected at The Jikei University Daisan Hospital. Mucus production was detected in all cases, in which ovarian-like stroma was absent but bile duct communication was present. The 3 cases were of the pancreatobiliary subtype, the gastric subtype, or the oncocytic subtype. The histologic findings in all cases were cystadenocarcinoma. With curative resection all patients survived more than 3 years. In summary, curative resection improves survival for IPNB more than for ordinary cholangiocarcinoma. (Jikeikai Med J 2016 ; 63 : 31-6)
