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. 2016:24:18-21.
doi: 10.1016/j.ijscr.2016.04.036. Epub 2016 Apr 28.

Laparoscopic resection of a hepatic mucinous cystic neoplasm: A case report

Shinsaku Obara  1 , Takeo Nomi  2 , Ichiro Yamato  1 , Daisuke Hokuto  1 , Satoshi Yasuda  1 , Satoshi Nishiwada  1 , Chihiro Kawaguchi  1 , Takahiro Yoshikawa  1 , Takatsugu Yamada  1 , Hiromichi Kanehiro  1 , Yoshiyuki Nakajima  1
Affiliations

Laparoscopic resection of a hepatic mucinous cystic neoplasm: A case report

Shinsaku Obara et al. Int J Surg Case Rep. 2016.

Abstract

Introduction: We aimed to present a case of hepatic mucinous cystic neoplasm (MCN-H) that was completely resected by laparoscopy.

Presentation of case: A 47-year-old female exhibited mild elevation of serum liver enzyme levels. Abdominal computed tomography revealed a 45-mm multilocular cystic tumor in segment IV of the liver, along with intermittent border calcification and minimal wall thickness. Magnetic resonance imaging revealed fluid-to-fluid level in the cystic tumor, thereby increasing the suspicion of a mild hemorrhage. The patient underwent laparoscopic liver resection (LLR) with a diagnosis of suspected mucinous cystic neoplasm of the liver. The entire tumor was successfully resected with a laparoscopic approach. The resected specimen was a 4.2×3.3×2.2-cm cystic tumor. Histological findings revealed mucin-producing singular epithelium and ovarian-like stroma. The tumor was diagnosed as a MCN-H with no malignancy.

Discussion: This is the first report in which a MCN-H was completely resected by laparoscopy. MCN-H is rare and is observed in only<5% of liver cystic tumors. MCN-H has been reported to have the malignant potential. And complete resection might be a good treatment option. Along with technical development, LLR has been indicated for benign liver tumors to date. Benign liver tumors are commonly observed in young females. The smaller incisions of the laparoscopic approach might provide cosmetic advantages for patients.

Conclusion: We presented the first case of a MCN-H completely resected by laparoscopy. Benign tumors and tumors with malignant potential might be good indications for a laparoscopic surgery.

Keywords: Case report; Laparoscopic liver resection; Liver; Mucinous cystic neoplasm; Ovarian-like stroma.

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Figures

Fig. 1
Fig. 1
A multilocular cystic tumor was observed in segment IV of the liver. The tumor was 45 mm in diameter and had septations. CT revealed calcification of the cystic wall and slight wall thickness. There was no mural nodularity or communication to bile ducts.
Fig. 2
Fig. 2
T2-weighted MRI revealed a high intensity on the ventral side and low intensity on the backside of the tumor. Fluid-fluid level was observed on the border, thereby leading to the suspicion that mild hemorrhage may have occurred in the cystic tumor.
Fig. 3
Fig. 3
The cyst was covered with single layer of epithelial cells (hematoxylin–eosin stain, left). Ovarian-like stroma was observed showing positive immunostaining for both estrogen (upper right) and progesterone receptors (bottom right).
See this image and copyright information in PMC

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