Ciliated hepatic foregut cyst: two case reports in children and review of the literature

Abstract

Ciliated hepatic foregut cyst (CHFC) is a rare lesion which originates from detached hepatic diverticulum or from detachment and migration of buds from the esophageal and bronchial regions of the foregut which subsequently get entrapped by the liver during the early embryonic development of the foregut. CHFCs are mostly seen in adults and are rarely reported in children, with only about 10 cases reported in this age group. Hereby, we present two cases of CHFC in two 3.5-year-old boys; one of them had cystic lesion at medial segment of left lobe of liver (common site), and in the other one it was located at right lobe of liver (less common site). Histologically, both cysts had four layers composed of inner ciliated, pseudostratified, columnar epithelium; subepithelial connective tissue; smooth muscle layer; and an outer fibrous layer.

Figure 1

(a) CT shows a simple 3.7 × 2.8 cm subcapsular liver cyst in median segment of left lobe (left arrow). (b) US shows a 3.6 × 3.2 cm heterogeneous lesion in right lobe of liver (left arrow).

Figure 2

(a) Liver tissue and cyst wall composed of four typical layers (H&E ×250). (b) Four layers of cyst higher magnification (H&E ×400). (c) The fibrous layers of the cyst are stained green by Masson trichrome stain (⇕) (Masson trichrome stain ×400).