Giant biliary cystadenoma

Abstract

Biliary cystadenoma (BCA) is a rare cystic tumor which originates from intrahepatic or extrahepatic biliary ducts. Intrahepatic BCAs are more common, demonstrate a female predominance, and generally asymptomatic. Radiographic evaluation assists in the preoperative differentiation of these tumors from other cystic liver masses while resection remains the only means for definitive diagnosis. We report a case of massive mucinous intrahepatic BCA initially diagnosed as a nonresectable malignancy presenting in a female patient with progressively increasing abdominal pain and girth. Enucleation of the mass with non-anatomic resection was employed for surgical management of this intrahepatic BCA.

Fig. 1

Computed tomography demonstrating large intrahepatic septated cystic lesion

Fig. 2a

Gross appearance of Hepatic cystadenoma.Fig. 2b & 2c: Gross appearance of enucleated Hepatic Cystadenoma following Decompressive Cystotomy.Fig. 2d: Exposed Hepatic Parenchyma following Argon Beam Coagulation and Thrombin – Soaked Gelfoam Application.Fig. 2e: Gross Specimen demonstrating Ovarian Stroma Characteristics.Fig. 2f: Photomicrograph demonstrates normally arranged cuboidal epithelium and mucin overlying dense ovarian stroma.Fig. 2g: Photomicrograph demonstrates infiltrative atypical glands.