Extrahepatic biliary cystadenoma: a rare cause of biliary obstruction

Abstract

Biliary cystadenoma is a rare tumor of the biliary tree and a rare cause of obstructive jaundice. Most are intrahepatic, and pure extrahepatic biliary cystadenoma is less common. Cases are more common in women. Unless suspected, diagnosis of extrahepatic biliary cystadenoma is often delayed. Here, we report the case of a young woman with extrahepatic biliary cystadenoma who presented at Raja Isteri Pengiran Anak Saleha Hospital with obstructive jaundice initially thought to be due to a large biliary stone based on the endoscopic cholangiogram image. She was successfully managed with resection of the cystadenoma.

Keywords: Biliary tract disease; Biliary tract neoplasm; Choledocholithiasis; Jaundice; Obstructive.

Figure 1

Cholangiogram showing a large oval shaped filling defect in the proximal common bile duct.

Figure 2

Resected specimen showing cystic structures with areas of hemorrhages.

Figure 3

(a) Hematoxylin (purple) and eosin (pink/red) stain showing cyst lined with a single layer cuboidal cell consistent of a biliary cystadenoma, 40x magnification. (b) Positive staining for vemintin (brown) showing subepithelial mesenchymal layer of plump spindle shaped cells (ovarian-like stroma), 40x magnification.