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Cholangioscopy revealed translucent oval masses with capillary vessels attached to the bile duct walls. The surface was mostly smooth yet partially irregular with redness, suggesting that the masses were epithelial neoplasms. Histological findings of cholangioscopy\u2010guided targeted biopsies of the mass showed subepithelial spindle cell proliferation with no atypical epithelium. The patient underwent an extrahepatic bile duct resection to confirm the pathological diagnosis. Immunohistochemistry of surgical specimens revealed that the spindle cells were positive for estrogen and progesterone receptors. Finally, the cystic lesion with ovarian\u2010like stroma was diagnosed as a mucinous cystic neoplasm with low\u2010grade intraepithelial neoplasia. This is the first report of cholangioscopic imaging of a biliary mucinous cyctic neoplasm. Cholangioscopic imaging can be helpful in the differential diagnosis of biliary neoplasms and in the determination of treatment strategies.<\/jats:p>","DOI":"10.1002\/deo2.349","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T02:42:29Z","timestamp":1710556949000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A rare case of resection of a mucinous cystic neoplasm originating from the extrahepatic bile duct with cholangioscopic imaging"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8765-6074","authenticated-orcid":false,"given":"Yoshiharu","family":"Masaki","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Sapporo Medical University School of Medicine  Hokkaido 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