Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7886-7892
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7886
Rare monolocular intrahepatic biliary cystadenoma: A case report
Chen-Hao Che, Zhen-Hua Zhao, Hui-Ming Song, Yuan-Yuan Zheng
Chen-Hao Che, The First Clinical Medical School, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Zhen-Hua Zhao, Department of Radiology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing 312000, Zhejiang Province, China
Hui-Ming Song, Yuan-Yuan Zheng, Department of Ultrasonography, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing 312000, Zhejiang Province, China
Author contributions: Che CH reviewed the literature and drafted the manuscript; Zhao ZH analyzed the case and contributed to manuscript drafting; Song HM and Zheng YY prepared the case and collected the clinical data; All authors approved the final version to be submitted.
Supported by Shaoxing Municipal Science and Technology Project, No. 2020A13027; and Key Laboratory of Functional Molecular Imaging of Tumor and Interventional Diagnosis and Treatment of Shaoxing City.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Yuan Zheng, MBBS, Chief Physician, Department of Ultrasonography, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), No. 568 Zhongxing North Road, Yuecheng District, Shaoxing 312000, Zhejiang Province, China. 13735299770@126.com
Received: April 19, 2021
Peer-review started: April 19, 2021
First decision: May 24, 2021
Revised: May 27, 2021
Accepted: July 21, 2021
Article in press: July 21, 2021
Published online: September 16, 2021
Abstract
BACKGROUND

Intrahepatic biliary cystadenoma (IBC) is a rare benign hepatic tumor that is often misdiagnosed as other hepatic cystic diseases. Therefore, imaging examinations are required for preoperative diagnosis. Contrast-enhanced ultrasound (CEUS) has gained increasing popularity as an emerging imaging modality and it is considered the primary method for screening IBC because of its specificity of performance. We describe an unusual case of monolocular IBC and emphasize the performance of CEUS.

CASE SUMMARY

A 45-year-old man complained of epigastric pain lasting 1 wk. He had no medical history of hepatitis, liver cirrhosis or parasitization. Physical examination revealed a mass of approximately 6 cm in size in the upper abdomen below the subxiphoid process. Tumor marker tests found elevated CA19-9 levels (119.3 U/mL), but other laboratory tests were unremarkable. Ultrasound and computerized tomography revealed a round thick-walled mass measuring 83 mm × 68 mm located in the left lateral lobe of the liver that lacked internal septations and manifested as a monolocular cystic structure. CEUS demonstrated that in the arterial phase, the anechoic area manifested as a peripheral ring with homogeneous enhancement. The central part presented with no enhancement. During the portal phase, the enhanced portion began to subside but was still above the surrounding liver tissue. The patient underwent left partial liver lobectomy and recovered well without tumor recurrence or metastasis. Eventually, the results of pathological examination confirmed IBC.

CONCLUSION

A few IBC cases present with monolocular characteristics, and the lack of intracystic septa in imaging performance cannot exclude IBC.

Keywords: Intrahepatic biliary cystadenoma, Monolocular, Diagnosis, Imaging performance, Contrast-enhanced ultrasound, Case report

Core Tip: We report the case of a 45-year-old man with intrahepatic biliary cystadenoma (IBC), which infrequently manifests as a monolocular cystic structure because of the lack of intracystic septa. This case was diagnosed by imaging examinations, especially contrast-enhanced ultrasound. Herein, we have summarized the characteristics of contrast-enhanced ultrasound performance for IBC to achieve a more accurate diagnosis. Moreover, it is worth noting that the lack of intracystic septa in this case cannot be regarded as imaging evidence to exclude IBC.