Biliary Cystadenoma: A Case Report

Abstract

Biliary cystadenoma is a rare cystic neoplasms of liver that usually occurs in middle-aged women characterized by multiloculated cysts with internal septae and mural nodules. Unilocular biliary cystadenomas are rare and are difficult to differentiate from other cysts by radiology. Biliary cystadenomas are slow growing benign lesions that are easily resectable with a reported recurrence rate of 90% when the resection is incomplete. We present a case of 65-year-old male with unilocular biliary cystadenoma with mesenchymal stroma who presented with abdominal pain and distension. Laparotomy followed by cystectomy was done and postoperative period was uneventful with no abnormal biochemical, heamatological or imaging findings. Preoperative radio-imaging techniques may not always be helpful in arriving at a specific diagnosis in such cases. Hence thorough sampling and a careful histopathological examination is considered gold standard for specific diagnosis.

Keywords: Benign liver lesion; Mesenchymal stroma; Unilocular.

[Table/Fig-1]:

Abdominal CT showing an unilocular cystic mass filling the right hypochondrium, epigastric region causing displacement of right kidney.

[Table/Fig-2]:

Gross photograph revealing a unilocular cystic lesion with a smooth wall lining.

[Table/Fig-3a]:

Lesion composed of biliary type of epithelium with underlying mesenchymal stroma resembling ovarian stroma. (H&E, 100X).

[Table/Fig-3b]:

Lesion composed of biliary type of columnar epithelium with focally pseudostratified areas and basally oriented nuclei and apical mucin with no atypia with mesenchymal stroma. (H&E, 400X).

[Table/Fig-4]:

Photomicrograph showing cytokeratin positivity in epithelial cells. Pancytokeratin (100X).