[Cystic tumor on the porta hepatis]

Area of Science:

• Gastroenterology and Hepatobiliary Pathology
• Surgical Pathology
• Oncology

Background:

• Pancreatic cancer is a significant concern for cystic lesions in the porta hepatis.
• Rapid on-site evaluation (ROSE) is crucial for intraoperative diagnosis.
• Differential diagnosis of hepatobiliary masses requires comprehensive histopathological analysis.

Observation:

• A cystic lesion in the porta hepatis of a 64-year-old female patient was evaluated.
• Initial rapid section diagnostics suggested a highly differentiated mucinous adenocarcinoma due to glandular proliferation and mucoid material.
• Conventional histology and immunohistochemistry were performed for definitive diagnosis.

Findings:

• Conventional paraffin-section histology and immunohistochemistry ruled out mucinous adenocarcinoma.
• The final diagnosis was an adenomatoid tumor.
• Adenomatoid tumors are typically found in the genital area and can mimic adenocarcinoma.

Implications:

• This case underscores the importance of considering extragenital adenomatoid tumors in the differential diagnosis of cystic lesions in the hepatobiliary system.
• Accurate histopathological and immunohistochemical evaluation is essential to differentiate benign entities from malignancies.
• Such diagnoses can alter patient management and prognosis, avoiding unnecessary aggressive treatment for pancreatic cancer.