Mucinous Cystadenoma: A Rare Hepatic Tumor in a Child

Abstract

Mucinous cystadenomas (MCAs) of the liver (also called hepatic biliary cystadenomas) are rare tumors that comprise about 5% of cystic masses of the liver in adults. These slow-growing lesions most commonly occur in middle-aged individuals, with a female sex predominance. Herein, we present a MCA in a 6-year-old male, one of only very few such cases described in the pediatric literature to date. Although MCAs are generally considered benign lesions, malignant transformation rarely occurs. The recurrence rate is high when partial cyst excision is performed. Therefore, complete surgical cyst resection with clinical follow-up, including imaging, is warranted.

Keywords: children; liver mass; liver tumors; mucinous cystadenoma; pediatrics.

Figure 1

(A) Magnetic resonance imaging of the liver (with Eovist contrast) showing a cystic lesion in the left hepatic lobe measuring 6.0 cm × 6.1 cm × 3.8 cm. There is thin enhancement of septations seen within the lesion. (B) Gross pathology showing a large, well-circumscribed mass with surrounding liver parenchyma. (C) Serial sectioning of the mass revealed a cyst-like appearance with clear serous fluid filling the central portion. (D) The resected cyst is lined by mucin-type epithelium ranging from low cuboidal to stratified-columnar with frequent papillary tufting. No significant nuclear pleomorphism or loss of nuclear polarity is noted. The histologic findings are best classified as mucinous cystic neoplasm with low-intermediate grade dysplasia (original magnification 20×, hematoxylin and eosin).