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Biliary cystadenoma with bile duct communication depicted on liver-specific contrast agent-enhanced MRI in a child
Gianluca Marrone1, Giuseppe Maggiore, Vincenzo Carollo
1Diagnostic and Interventional Radiology, Mediterranean Institute of Transplantation and High Specialization Therapy, Palermo, Italy. gmarrone@ismett.edu
Insights
Biliary cystadenoma, a rare pediatric liver tumor, was diagnosed in a 9-year-old boy using MRI and a liver-specific contrast agent. Surgical resection confirmed the diagnosis and ensured a full recovery.
Area of Science:
- Hepatobiliary Medicine
- Pediatric Radiology
- Surgical Oncology
Background:
- Biliary cystadenoma is a rare cystic neoplasm of the biliary ducts, typically affecting middle-aged women but exceptionally occurring in children.
- Early diagnosis and intervention are crucial due to the potential for malignant transformation.
Observation:
- A 9-year-old male presented with symptoms necessitating advanced imaging.
- Magnetic Resonance Imaging (MRI) was performed utilizing gadoxetic acid, a novel liver-specific contrast agent eliminated via the biliary system.
- The MRI revealed a multiloculated cystic mass with clear communication to the biliary tree.
Findings:
- The imaging characteristics strongly suggested biliary cystadenoma.
- The lesion was surgically resected due to its malignant potential.
- Histopathological analysis confirmed the diagnosis of biliary cystadenoma.
Implications:
- This case highlights the utility of liver-specific MRI contrast agents in diagnosing rare pediatric biliary neoplasms.
- Early diagnosis and complete surgical resection are vital for favorable outcomes in pediatric biliary cystadenoma.
- Further research into the specific imaging features and management of pediatric biliary cystadenoma is warranted.
Abstract:
Biliary cystadenoma is a benign, but potentially malignant, cystic neoplasm of the biliary ducts occurring most commonly in middle-aged females and very rarely in children. We present a 9-year-old boy with biliary cystadenoma, diagnosed by MRI using a new liver-specific contrast agent (gadoxetic acid) that is eliminated by the biliary system. The images clearly demonstrate the communication between the multiloculated cystic mass and the biliary tree, suggesting the possibility of biliary cystadenoma. Due to the malignant potential of a cystadenoma, the lesion was resected. The resection was complete and the postoperative course was uneventful.
