Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 21, 2006; 12(35): 5735-5738
Published online Sep 21, 2006. doi: 10.3748/wjg.v12.i35.5735
Obstructive jaundice due to hepatobiliary cystadenoma or cystadenocarcinoma
Deha Erdogan, Olivier RC Busch, Erik AJ Rauws, Otto M van Delden, Dirk J Gouma, Thomas M van Gulik
Deha Erdogan, Olivier RC Busch, Dirk J Gouma, Thomas M van Gulik, Department of Surgery, Academic Medical Center, University of Amsterdam, The Netherlands
Erik AJ Rauws, Department of Hepatology, Academic Medical Center, University of Amsterdam, The Netherlands
Otto M van Delden, Department of Surgery Radiology, Academic Medical Center, University of Amsterdam, The Netherlands
Author contributions: All authors contributed equally to the work.
Correspondence to: TM van Gulik, MD, Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Telephone: +31-20-5665570 Fax: +31-20-6976621
Received: June 20, 2006
Revised: July 1, 2006
Accepted: July 7, 2006
Published online: September 21, 2006

Hepatobiliary cystadenomas (HBC) and cystadenocarcinomas are rare cystic lesions. Most patients with these lesions are asymptomatic, but presentation with obstructive jaundice may occur. The first patient presented with intermittent colicky pain and recurrent obstructive jaundice. Imaging studies revealed a polypoid lesion in the left hepatic duct. The second patient had recurrent jaundice and cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP) showed a cystic lesion at the confluence of the hepatic duct. In the third patient with intermittent jaundice and cholangitis, cholangioscopy revealed a papillomatous structure protruding into the left bile duct system. In the fourth patient with obstructive jaundice, CT-scan showed slight dilatation of the intrahepatic bile ducts and dilatation of the common bile duct of 3 cm. ERCP showed filling of a cystic lesion. All patients underwent partial liver resection, revealing HBC in the specimen. In the fifth patient presenting with obstructive jaundice, ultrasound examination showed a hyperechogenic cystic lesion centrally in the liver. The resection specimen revealed a hepatobiliary cystadenocarcinoma. HBC and cystadenocarcinoma may give rise to obstructive jaundice. Evaluation with cross-sectional imaging techniques is useful. ERCP is a useful tool to differentiate extraductal from intraductal obstruction.

Keywords: Liver, Hepatobiliary cystadenoma, Cystadenocarcinoma, Obstructive jaundice, Endoscopic retrograde cholangiopancreatography