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World J Gastroenterol. Dec 28, 2009; 15(48): 6134-6136
Published online Dec 28, 2009. doi: 10.3748/wjg.15.6134
A special growth manner of intrahepatic biliary cystadenoma
Bin Yi, Qing-Bao Cheng, Xiao-Qing Jiang, Chen Liu, Xiang-Ji Luo, Bai-He Zhang, Meng-Chao Wu, Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Hui Dong, Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Author contributions: Yi B, Cheng QB and Jiang XQ designed the procedure and took part in the patient management; Dong H was responsible for the pathological work; Yi B and Cheng QB analyzed the data and wrote the paper; all the authors discussed the results and commented on the manuscript; Yi B and Cheng QB contributed equally to this work.
Correspondence to: Xiao-Qing Jiang, MD, Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China. firstname.lastname@example.org
Telephone: +86-21-81875281 Fax: +86-21-81875281
Received: October 22, 2009
Revised: November 18, 2009
Accepted: November 25, 2009
Published online: December 28, 2009
We report a case of a 56-year-old woman with intrahepatic biliary cystadenoma (IBC) accompanying a tumor embolus in the extrahepatic bile duct, who was admitted to our department on October 13, 2008. Imaging showed an asymmetry dilation of the biliary tree, different bile signals in the biliary tree, a multiloculated lesion and an extrahepatic bile duct lesion with internal septation. A regular left hemihepatectomy en bloc was performed with resection of the entire tumor, during which a tumor embolus protruding into the extrahepatic bile duct and originating from biliary duct of segment 4 was revealed. Microscopically, the multiloculated tumor was confirmed to be a biliary cystadenoma with an epithelial lining composed of biliary-type cuboidal cells and surrounded by an ovarian-like stroma. An aggressive en bloc resection was recommended for the multiloculated lesion. Imaging workup, clinicians and surgeons need to be aware of this different presentation.