Hepatobiliary Mucinous Cystadenoma of the Liver: A Case Report of a One-Year-Old Girl

Case Report

Austin J Clin Case Rep. 2017; 4(3): 1121.

Hepatobiliary Mucinous Cystadenoma of the Liver: A Case Report of a One-Year-Old Girl

Amir Mohamadain¹, Sami A Taha¹, Azza A Abdelssatir² and Ahmed A Abdalla³*

¹Department of Surgery, Al Neelain University, Sudan

²Ministry of Health, Histopathology, Khartoum, Sudan

³Departments of Surgery, University of Gezira, Sudan

*Corresponding author: Ahmed A Abdalla, Departments of Surgery, University of Gezira, Sudan; Email: hantoub22@hotmail.com

Received: April 03, 2017; Accepted: July 05, 2017; Published: July 31, 2017

Abstract

Hepatobiliary cystadenoma is a rare cystic tumor of the liver, they account for less than 5% of nonparasitic cysts of the liver. We are reporting her an oneyear- old Sudanese girl with hepatobiliary cystadenoma. Ultrasound (US) and Computerized Tomography (CT) are most important for tumor diagnosis, but differential diagnosis with other cystic tumors of the liver and parasitic infection is difficult preoperatively. Complete surgical liver resection or enucleation is the treatment of choice.

Keywords: Hepatobiliary cystadenoma; Cystadenocarcinoma; Hydatid cyst

Introduction

Primary hepatic tumors account for about 5%-6% of all intraabdominal tumours in children and represent between 0.5% and 2.0% of all pediatric neoplasms [1]. Hepatobiliary cystadenoma is a rare [2] cystic tumor of the liver, they account for less than 5% of nonparasitic cysts of the liver [3], affects females predominantly with age range from 40 to 60 years at the time of initial diagnosis [4].

All the cystadenomas were multilocular with benign cuboidal to columnar epithelium, and 44 (85%) had densely cellular spindle cell (“ovarian-like”) stromata [5]. It is mostly benign with potential for malignant transformation [6].

Recent developments in diagnostic radiology techniques might help in differentiating cystadenoma from cystadenocarcinoma [7]. Internal septation and polypoid protrusions on CT scan should increase concern for malignancy [8] and hence complete resection is necessary due to this malignant potential of cystadenoma [7].

The aim of this case report is to demonstrate its clinical presentation, preoperative evaluation, and treatment.

Case Presentation

A 12-month-old girl presented with right upper abdominal mass for 40 days, increasing in size gradually without constitutional symptoms. The examination revealed soft lax abdomen, not tender and the liver was approaching the umbilicus. Laboratory tests were normal except a slightly elevated SGOT (40 u/L) and CA 19-9 (79 u/ ml). Ultrasound scan showed large well-defined, thin wall cyst with septation occupying most of the right lobe of the liver, measuring 9.5 x 5.5 cm, with no calcifications, and the impression was a hydatidcyst. And serology was negative for hydatid disease.

Contrast CT scan showed large rounded thick wall cystic mass with septations occupying segment V & V1 suggestive of hamartoma or hydatid cyst (Figure 1).