Obstructive jaundice caused by a biliary mucinous cystadenoma in a woman: a case report

Journal of Medical Case Reports

Suraj Ruwan Wijesuriya¹  Kemal Ismail Deen¹  Chandika Liyanage¹  Pramodh C Chandrasinghe¹ 

[1] Department of Surgery, University Surgical Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka

关键词: Obstructive jaundice;    Mucinous cystadenoma;    Liver cyst;    Benign liver cyst;   

Others  :  824773
DOI  :  10.1186/1752-1947-7-278

 received in 2013-05-13, accepted in 2013-09-30,  发布年份 2013

【 摘 要 】

Introduction

Mucinous cystadenoma of the liver is a rare (less than 5%) neoplasm. This condition is more common in young women and accounts for non-specific symptoms. Cyst adenomas commonly affect the intrahepatic system (90%) and are rarely found in the extrahepatic biliary system or affecting both the systems.

Case presentation

A 39-year-old Sinhalese woman presented with features of obstructive jaundice and was found to have a biliary neoplasm on imaging. In the absence of a definitive diagnosis despite extensive imaging she underwent preoperative endoscopic biliary drainage followed by a left hemihepatectomy with Roux-en-Y hepaticojejunostomy. A pathological examination of the specimen revealed an obstruction of the bile duct caused by a biliary mucinous cystadenoma affecting both the intrahepatic and extrahepatic systems.

Conclusions

Biliary mucinous cystadenoma rarely present with obstructive jaundice affecting both intrahepatic and extrahepatic ducts. Exhaustive investigation might not help in the diagnosis and may need to be treated based on clinical judgment. The definitive treatment modality is surgery due to its malignant potential. The operative procedure is technically demanding and is best performed at specialist centers to minimize complications.

【 授权许可】

   
2013 Chandrasinghe et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Wang YJ, Lee SD, Lai KH, Wang SS, Lo KJ: Primary biliary cystic tumors of the liver. Am J Gastroenterol 1993, 88:599-603.
• [2]Beretta E, De Franchis R, Staudacher C, Faravelli A, Primignani M, Vecchi M, Conti E, Di Carlo V: Biliary cystadenoma: an uncommon cause of recurrent cholestatic jaundice. Am J Gastroenterol 1986, 8:138-140.
• [3]Davies W, Chow M, Nagorney D: Extrahepatic biliary cystadenomas and cystadenocarcinoma. Report of seven cases and review of the literature. Ann of Surg 1995, 222:619-625.
• [4]Lauffer JM, Baer HU, Maurer CA, Stoupis C, Zimmerman A, Buchler MW: Biliary cystadenoma of the liver: the need for complete resection. Eur J Can 1998, 34:1845-1851.
• [5]Florman SS, Slakey DP: Giant biliary cystadenoma: case report and literature review. Am J Gastroenterol 2001, 67:727-732.
• [6]Preetha M, Chung AYF, Lim-Tan SK, Lim DTH, Thug CH: Intrahepatic biliary cystadenoma presenting with obstructive jaundice. Asian J Surg 2004, 2:243-245.
• [7]Zhou JP, Dong M, Zhang Y, Kong FM, Guo KJ, Tian YL: Giant mucinous biliary cystadenoma: a case report. Hepatobiliary Pancreat Dis Int 2007, 6:101-103.
• [8]Kim JY, Kim SH, Eun HW, Lee MW, Lee JY, Han JK, Choi BI: Differentiation between biliary cystic neoplasms and simple cysts of the liver: accuracy of CT. Am J Roentgenol 2010, 195:1142-1148.
• [9]Tsui WMS, Adsay NV, Crawford JM: Mucinous cystic neoplasms of the liver. In World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System. Edited by Bosman FT, Carneiro F, Hruban RH, Theise ND. Lyon: IARC Press; 2010:236-238.
• [10]Zen Y, Pedica F, Patcha VR, Capelli P, Zamboni G, Casaril A, Quaglia A, Nakanuma Y, Heaton N, Portmann B: Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct. Mod Pathol 2011, 24:1079-1089.
• [11]Thomas KT, Welch D, Trueblood A, Sulur P, Wise P, Gorden DL, Chari RS, Wright JK Jr, Washington K, Pinson CW: Effective treatment of biliary cystadenoma. Ann Surg 2005, 241:769-775.