Multiple intrahepatic pancreatic pseudocyst (MIHPPs): an overlooked and misdiagnosed entity

Pancreatitis and pseudo-pancreatic cysts are frequently encountered entities; however, intrahepatic pseudocysts presenting as large number of liver cysts with absence of overt signs of pancreatitis has never been reported in literature. Here, we report an interesting case of multiple intrahepatic pancreatic pseudocysts (MIHPPs), a challenging diagnosis to be kept in mind while dealing with complex cystic lesions of liver. Pseudocysts are common complication of pancreatitis, often these are located within the vicinity of the pancreas in the lesser sac and the retroperitoneum. Extra pancreatic location of these cysts within the liver is a diagnosis often missed, with only 50 odd cases reported in literature till date. Most of these reported cases are either subcapsular in location or limited in number to one or two lesions. Although rare, possibility of MIHPPs is an important diagnosis that should be kept in mind while considering list of differentials for complex cystic lesions of the liver even in the absence of overt signs of pancreatitis.