Biliary cystadenocarcinoma diagnosed with real-time contrast-enhanced ultrasonography: Report of a case with diagnostic features

Figure 1 Biliary cystadenocarcinoma. Computed tomography shows a huge cystic tumor (arrowheads) in the left liver lobe, with no clear septations and solid components.

Figure 2 Biliary cystadenocarcinoma. A: Conventional sonography shows a multilocular cystic lesion in left lobe of the liver with nodular thickening of internal septa and mural nodules projecting into the cyst (arrow); B: Conventional sonography shows septal calcifications or stones (arrowhead); C: Color doppler flow imaging (CDFI) shows affluent vascularity in the internal septa (arrows).

Figure 3 Biliary cystadenocarcinoma. A: Contrast enhanced ultrasound (CEUS) shows hyperenhancement of the cystic wall, internal septations and intracystic solid portions during the arterial phase (arrows); B: CEUS shows hypoenhancement of the cystic wass, internal septations and intracystic solid portions during the portal and late phases (arrowheads).

Figure 4 Biliary cystadenocarcinoma. A and B: Magnetic resonance imaging (MRI) scans showing a multilocular cyst in the left lobe of the liver.

Figure 5 Biliary cystadenocarcinoma. A: Gross appearance of a cross-section of the formalin fixed specimen showing a multilocular mucinous cyst; B: Microscopically, tumor tissues showing moderately differentiated adenocarcinoma with a papillary growth pattern (HE, original magnification × 100).