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Case Reports
. 2018 Sep 1:2018:bcr2018226077.
doi: 10.1136/bcr-2018-226077.

Simultaneous occurrence of hepatic hydatid cyst and mucinous cystadenoma of the liver in a middle-aged female patient: report of a rare case

Venkiteswaran Muralidhar  1 , R G Santhaseelan  1 , Muzamil Ahmed  1 , Prakash Shanmuga  1
Affiliations
Case Reports

Simultaneous occurrence of hepatic hydatid cyst and mucinous cystadenoma of the liver in a middle-aged female patient: report of a rare case

Venkiteswaran Muralidhar et al. BMJ Case Rep. .

Abstract

We present a rare case of simultaneous occurrence of mucinous cystadenoma of the liver (MCN-L) and a hepatic hydatid cyst (HD-L) in a middle-aged female patient. This is the first case report of a common disease (HD-L) and a rare condition (MCN-H) occurring concurrently. MCN-H of the left lobe was inadequately resected in a rural centre leading to recurrence. She presented with a large upper abdominal lump and upper gastrointestinal symptoms. Radiological investigations and an ultrasound revealed a multilobulated cyst involving both lobes of the liver. There was no ascites. Liver function, basic haematology and renal function were normal. The recurrent MCN-L was removed totally. There was no communication between the MCN-L and the right lobe cyst, which turned out to be a hydatid cyst. The hydatid cyst was evacuated. She was discharged on albendazole and is asymptomatic with no recurrence at 8 months.

Keywords: gastrointestinal surgery; infection (gastroenterology); tropical medicine (infectious disease).

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Ultrasound of the liver showing a residual lesion 1 month after laparoscopic cystadenectomy of a left lobe mucinous cystadenoma of the liver.
Figure 2
Figure 2
MRI (T1-weighted image) of the liver showing a hypointense multilobulated cyst involving both the lobes of the liver: hydatid cyst (red arrow), cystadenoma (blue arrow).
Figure 3
Figure 3
MRI (T2-weighted image) of the liver showing a hyperintense multilobulated cyst involving both the lobes of the liver: hydatid cyst (red arrow), cystadenoma (blue arrow).
Figure 4
Figure 4
CT scan showing lobulated liver cysts occupying both the lobes of the liver hydatid cyst (red arrow) and cystadenoma (blue arrow). The hydatid cyst is showing a water lily sign suggestive of hydatid cyst (WHO type CE3) (red arrow head).
Figure 5
Figure 5
Daughter cysts and the germinal epithelium evacuated during surgery (blue arrow).
Figure 6
Figure 6
Magnified close-up view of a daughter cyst.
Figure 7
Figure 7
Histopathology of the excised left hepatic lobe cyst showing cystic spaces lined by a single layer of tall columnar epithelium, with a basally placed nuclei amidst an ovarian-like stroma suggestive of mucinous cystadenoma.
See this image and copyright information in PMC

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