Biliary Cystadenoma with High Dysplasia Detected Incidentally in a Young Patient Admitted for Percutaneous Abscess Drainage

Abstract

Biliary cystadenomas are uncommon lesions with clinical and radiological characteristics that overlap with other cystic liver lesions. Here, we intended to discuss a biliary cystadenoma found in a 37-year-old female patient who had been treated for a liver abscess and had been sent to our clinic with a long-term hydatid cyst diagnosis.

Keywords: Abscess; biliary cystadenocarcinoma; biliary cystadenoma; computed tomography; excision; ultrasonography.

Figure 1

Imaging prior to the treatment. On axial CT (a-h) and MRI (i-l) images with intravenous contrast, the BCAC (asterisk), inferior vena cava (IVC; yellow arrowhead), left hepatic vein (black arrow), middle hepatic vein (white arrow), right hepatic vein (blue arrow) and portal vein (green arrowhead) are shown. Because of the mass effect, there is a deviation in the middle and left hepatic veins as well as IVC compression at the hepatic level (yellow arrowhead).

Figure 2

CT-guided drainage of the lesion with a catheter.

Figure 3

Post-treatment magnetic resonance imaging shows the multiseptal and multiloculated cystic lesion. (a) axial T1 weighted imaging (WI), (b) T2-fat saturated image, (c) diffusion WI, (d) apparent diffusion coefficient, (e) contrast-enhanced axial plan, (f) coronal plan T2-WI.

Figure 4

Intraoperative images show (a) Biliary cyst adenoma (asterisk) compressing the right and left lobes and the caudate lobe in the central sector, (b) the area of previously placed drainage catheter at the junction of segment 4-8 (black arrow), (c) Inferior vena cava (long arrow) with portal vein (arrows head) isolated in the central sector, (d) Inferior view of the vena cava (long arrow) after resection.