Giant complex hepatic cyst causing pseudocystitis: A case report

Abstract

Background: Hepatic cysts are common benign liver tumors that are typically asymptomatic. However, larger cysts, particularly giant liver cysts, can potentially induce symptoms. If the diameter of the cyst exceeds 10 cm, it can exert pressure on adjacent organs, leading to manifestations of corresponding symptoms. Here, we report the case of a complex giant hepatic cyst that caused pseudocystitis.

Case summary: A 16-year-old girl was admitted to our hospital with frequent and urgent urination. Ultrasonography revealed no obvious uterine adnexal abnormalities but showed a hypoechoic, cystic mass (173 mm × 84 mm × 138 mm) with clear boundaries, and an unclear blood flow signal in the abdominal cavity (extending from the lower edge of the left lobe of liver to the upper edge of the bladder). Abdominal contrast-enhanced computed tomography revealed a giant cystic mass in the abdominal and pelvic cavities, possibly originating from the liver, and a small amount of free fluid in the pelvic cavity, which subsequent magnetic resonance imaging confirmed. The imaging characteristics were consistent with a benign lesion. The patient underwent laparoscopic resection of the giant liver cyst with partial liver resection. Post-surgery her symptoms urinary symptoms were relieved completely and she was discharged on the sixth postoperative day.

Conclusion: Our patient presented with symptoms suggestive of pseudocystitis, stressing the need for considering possibilities of other etiologies and differential diagnoses.

Keywords: Case report; Giant hepatic cyst; Pseudocystitis; Symptoms.

Figure 1

Abdominal contrast-enhanced computed tomography images. Images show a huge cystic mass in the abdominal and pelvic cavities, possibly arising from the liver. A small amount of free fluid is present in the pelvic cavity. A: Middle abdomen; B: Lower abdomen; C: Pelvic cavity; D: Coronal plane of the abdomen; E: Sagittal plane of the abdomen.

Figure 2

Magnetic resonance imaging. Images show a large cystic mass in the abdominal and pelvic cavities that was considered a benign lesion. A small amount of free fluid is present in the pelvic cavity. A: Pelvic cavity; B: Enhanced pelvic cavity; C: Sagittal plane of the abdomen; D: Enhanced sagittal plane of the abdomen.

Figure 3

Postoperative specimen and pathological diagnosis. A: Postoperative specimen; B: Bile duct derived cyst liver tissue showing bleeding and a compression injury (liver tissue); C: A few red blood cells and histiocytes (ascites cell mass).