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Intrahepatic biliary cystadenoma presenting with obstructive jaundice
Madhukumar Preetha1, Alexander Y F Chung, Soo-Khim Lim-Tan
1Department of General Surgery, Singapore General Hospital, Singapore.
Asian Journal of Surgery
|November 27, 2004
Summary
This case report details an intrahepatic biliary cystadenoma (BCA) presenting as obstructive jaundice. Surgical resection was successful, highlighting imaging and treatment options for this rare bile duct neoplasm.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Oncology
- Diagnostic Imaging
Background:
- Biliary cystadenoma (BCA) is a rare cystic neoplasm arising from the biliary epithelium, often occurring in the liver.
- These tumors possess malignant potential and can present with vague or obstructive symptoms, complicating diagnosis.
- Early and accurate diagnosis is crucial for effective management and to prevent malignant transformation.
Observation:
- A patient presented with obstructive jaundice attributed to an unusual intrahepatic biliary cystadenoma.
- Computed tomography revealed dilated bile ducts with internal septa, and endoscopic retrograde cholangiography identified a filling defect.
- Intraoperative choledochoscopy confirmed a multiloculated mucinous polyp originating in the left intrahepatic duct.
Findings:
- Histological examination confirmed the resected mass as an intrahepatic mucinous biliary cystadenoma with mesenchymal stroma.
- The tumor caused significant obstruction of the common bile duct, leading to the jaundiced presentation.
- Left hemihepatectomy was the surgical approach chosen for complete tumor removal.
Implications:
- This case underscores the importance of considering rare biliary neoplasms in the differential diagnosis of obstructive jaundice.
- Advanced imaging techniques and intraoperative visualization are vital for precise localization and characterization of BCA.
- Surgical management, including hemihepatectomy, offers a curative option for intrahepatic biliary cystadenoma, with prognosis dependent on histological features.