Mucinous cystic neoplasm of the liver with biliary communication: case report and surgical therapeutic option

Rare Benign Focal Lesions of the Liver: Report of 2 Cases and Literature Review

Introduction

Benign lesions of the liver are very common findings, usually randomly discovered, especially during examinations for other indications. The frequent use of imaging modalities may be responsible for the statistical increase in the incidence of these findings.

Case Presentation

In this publication, we present the cases of 2 female patients with benign liver lesions, the occurrence of which is considered rare, and only a few dozen cases have been described worldwide. In both cases, clinical symptoms, diagnostic approach, and surgical treatment are presented.

Conclusion

Due to increasing availability of imaging methods, the occurrence of previously considered rare benign liver lesions increases as well. In many cases, the malignant potential of these findings remains unclear. Decision-making process should include a multidisciplinary board.

Liver Mucinous Cystic Neoplasm With Obstructive Jaundice

Biliary mucinous cystic neoplasms (BMCNs) are rare and slow-growing lesions that are usually discovered incidentally. They can imitate various other liver tumors. Here, we present a 31-year-old female patient who presented with complaints of abdominal pain, nausea, shortness of breath, and obstructive jaundice. Ultrasound showed a large, lobulated, cystic liver mass. Abdominal computed tomography (CT) scan showed features suggestive of a hydatid cyst or complicated liver cyst. A laparoscopic deroofing was performed and showed a liver cyst involving segments 2, 3, 4A, and 4B. Histopathology showed that the cyst wall was lined by columnar mucin-producing epithelium with multifocal areas of ovarian-like stroma, and the diagnosis of biliary mucinous cystic neoplasms was made. A one-year, follow-up radiological examination did not show any recurrence. BMCNs are quite rare. The nonspecific nature of the symptoms and radiological characteristics makes the diagnosis of BMCN challenging. Imaging modalities can aid in the diagnosis, but pathological examination is essential in confirming a definite diagnosis.

Mucinous cystic neoplasm of the liver: A case report

BACKGROUND

Mucinous cystic neoplasm of the liver (MCN-L) is a cyst-forming epithelial neoplasm. The most distinguishing feature is the ovarian-type subepithelial stroma on pathological examination.

CASE SUMMARY

An abdominal ultrasound incidentally revealed a liver tumor in a 32-year-old woman. Physical and laboratory examination results did not reveal any abnormalities. Enhanced abdominal computed tomography (CT) revealed a cystic space measuring 7.2 cm × 5.4 cm in the liver. Subsequent CT showed an increase in tumor size. Thus, we performed surgical resection of the tumor and gallbladder. Postoperative histopathological examination confirmed the diagnosis of MCN-L. At the 6-mo of follow-up, no recurrence was observed on ultrasound or CT.

CONCLUSION

Since preoperative diagnosis of MCN-L is difficult, active surgery is recommended and helpful for the diagnosis and treatment of MCN-L.

Mucinous Cystic Adenoma of the Liver: A Thought-Provoking Case of an Uncommon Hepatic Neoplasm

Patient: Male, 70-year-old

Final Diagnosis: Liver disease

Symptoms: Asymptomatic

Medication:—

Clinical Procedure: Hepatectomy

Specialty: Gastroenterology and Hepatology