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A HEPATIC CYST! IS THIS ALWAYS A TRIVIAL DIAGNOSIS? Ninos Anestis, Papaevangelou Ageliki³, Dimopoulou Ekaterini², Papakonstantinou Eleni², Douridas Gerasimos, Maletsikopoulos Stavros, Vidali Maria, Pougouras Ioannis, Iordanou Christos, Antonakas Panagiotis, Farazi Christos, Papandrikos John, Pierrakakis Stefanos Thriassion General Hospital, Department of Surgery ²Department of Pathology, ³Radiology Department We present a case of a hepatic biliary cystadenoma, focusing on its distinct character

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913 views1 page

Νίνος

A HEPATIC CYST! IS THIS ALWAYS A TRIVIAL DIAGNOSIS? Ninos Anestis, Papaevangelou Ageliki³, Dimopoulou Ekaterini², Papakonstantinou Eleni², Douridas Gerasimos, Maletsikopoulos Stavros, Vidali Maria, Pougouras Ioannis, Iordanou Christos, Antonakas Panagiotis, Farazi Christos, Papandrikos John, Pierrakakis Stefanos Thriassion General Hospital, Department of Surgery ²Department of Pathology, ³Radiology Department We present a case of a hepatic biliary cystadenoma, focusing on its distinct character

Uploaded by

Anestis Ninos
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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A HEPATIC CYST! IS THIS ALWAYS A TRIVIAL DIAGNOSIS?

Ninos Anestis, Papaevangelou Ageliki³, Dimopoulou Ekaterini², Papakonstantinou Eleni², Douridas Gerasimos, Maletsikopoulos Stavros,
Vidali Maria, Pougouras Ioannis, Iordanou Christos, Antonakas Panagiotis, Farazi Christos, Papandrikos John, Pierrakakis Stefanos

Thriassion General Hospital, Department of Surgery


²Department of Pathology, ³Radiology Department
A 35-year-old woman presented in our
accident and emergency department with
We present a case of a hepatic biliary cystadenoma, focusing on its distinct abdominal pain of sudden onset. On clinical
examination there were signs of diffuse
characteristics which can differentiate it from other benign lesions peritonitis together with a palpable epigastric
mass. Abdominal CT revealed free
intraperitoneal fluid and a multiloculated
cystic hepatic mass in its quadrate lobe. An
urgent laparotomy was performed with a
presumptive diagnosis of a ruptured hydatid
cyst. Intraoperative findings included a
perforated duodenal ulcer and a large
multiloculated intact hepatic cyst. After
closing the perforation, an unroofing of the
mass was performed. Because a direct biliary
communication was found, a cholocystectomy
was done and a T-tube was placed in the
CBD. The biliary communication was sealed
with a fine absorbable suture.
Histological examination concluded that the
CT showing a complex cyst and a cholangiography revealing a small bile leak cyst was a hepatic cystadenoma.
Retrospective study of CT films revealed a
Although very rare (200 cases reported in the literature), hepatic multiloculated mass with a regular thin wall
biliary cystadenomas must be included in the differential and fine intracystic septa, compatible with
the definitive pathologic diagnosis.
diagnosis of a complex cystic mass, as this premalignant entity Postoperative cholangiography showed a
needs excision even when it is asymptomatic. Excision or normal intahepatic tree and excluded the
unroofing of such complex lesions is mandatory, as pathological rarer intraductal papillary neoplasm with
cystic dilatation.
examination can only provide definitive diagnosis

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