Case Report
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World J Gastroenterol. Oct 7, 2013; 19(37): 6310-6314
Published online Oct 7, 2013. doi: 10.3748/wjg.v19.i37.6310
Giant biliary cystadenoma complicated with polycystic liver: A case report
Zhen-Zhen Yang, Yong Li, Jun Liu, Kuang-Fan Li, Ye-Hong Yan, Wei-Dong Xiao
Zhen-Zhen Yang, Yong Li, Jun Liu, Kuang-Fan Li, Ye-Hong Yan, Wei-Dong Xiao, Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Yang ZZ collected the clinical data and wrote the paper; Li Y, Yan YH, Liu J and Xiao WD performed the operation; Li KF assisted in the reference search.
Correspondence to: Yong Li, MD, Professor, Department of General Surgery, The First Affiliated Hospital of Nanchang University, No. 17, Yongwai Zhengjie, Nanchang 330006, Jiangxi Province, China. yfyly@163.com
Telephone: +86-791-88694131 Fax: +86-791-88694131
Received: July 13, 2013
Revised: August 13, 2013
Accepted: August 28, 2013
Published online: October 7, 2013
Processing time: 107 Days and 3.7 Hours
Abstract

Biliary cystadenoma (BCA) is a rare hepatic neoplasm. Although considered a benign cystic tumor of the liver, BCA has a high risk of recurrence with incomplete excision and a potential risk for malignant degeneration. Correct diagnosis and complete tumor excision with negative margins are the mainstay of treatment. Unfortunately, due to the lack of presenting symptoms, and normal laboratory results in most patients, BCA is hard to distinguish from other cystic lesions of the liver such as biliary cystadenocarcinoma, hepatic cyst, hydatid cyst, Caroli disease, undifferentiated sarcoma, intraductal papillary mucinous tumor, and hepatocellular carcinoma. Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) may be necessary. They demonstrate intrahepatic cystic lesions with features such as mural nodules, varying wall thickness, papillary projections, and internal septations. Nevertheless, surgery is still the only means of accurate diagnosis. Definitive diagnosis requires histological examination following formal resection. We describe a 57-year-old woman initially diagnosed with polycystic liver who was subsequently diagnosed with giant intrahepatic BCA in the left hepatic lobe. This indicates that both US physicians and hepatobiliary specialists should attach importance to hepatic cysts, and CT or MRI should be performed for further examination when a diagnosis of BCA is suspected.

Keywords: Biliary cystadenoma; Diagnosis; Hepatic cysts; Ultrasound

Core tip: We present a case of a 57-year-old woman who was diagnosed with polycystic liver ten years ago. She had intermittent abdominal discomfort and pain in the past 2 years. Last month, she was admitted to our hospital, and underwent exploratory laparotomy with left hepatic lobectomy, right liver cyst fenestration, and cholecystectomy. She was then diagnosed with giant biliary cystadenoma complicated with polycystic liver.