1
|
Rastogi R, Gupta S, Saigal S, Kumar M, Luthra R, Agarwal R, Aggarwal B. Successful Surgical Management of Giant Mucinous Cystic Neoplasm of Liver (MCN-L) Presenting With Peritoneal Rupture and Biliary Prolapse: Case Report and Review of Literature. J Clin Exp Hepatol 2024; 14:101441. [PMID: 38835811 PMCID: PMC11145330 DOI: 10.1016/j.jceh.2024.101441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/01/2024] [Indexed: 06/06/2024] Open
Abstract
Mucinous cystic neoplasms of liver (MCN-L) are generally considered benign indolent cystic liver lesions, not associated with significant clinical symptoms in majority of patients. However, rarely these benign-appearing lesions may have a complicated clinical course, presenting with jaundice, acute abdomen, or malignant transformation. We report one such rare clinical presentation of MCN-L presenting with obstructive jaundice and abdominal pain due to prolapse of cystic component in biliary system and peritoneal rupture occurring simultaneously. Despite the complex nature of presentation, it was successfully managed surgically with normal follow-up imaging.
Collapse
Affiliation(s)
- Ruchi Rastogi
- Department of Radiology, Max Superspeciality Hospital, Saket, New Delhi, 110017, India
| | - Subhash Gupta
- Centre for Liver and Biliary Sciences, Max Superspeciality Hospital, Saket, New Delhi, 110017, India
| | - Sanjiv Saigal
- Centre for Liver and Biliary Sciences, Max Superspeciality Hospital, Saket, New Delhi, 110017, India
| | - Mukesh Kumar
- Centre for Liver and Biliary Sciences, Max Superspeciality Hospital, Saket, New Delhi, 110017, India
| | - Rohan Luthra
- Department of Radiology, Max Superspeciality Hospital, Saket, New Delhi, 110017, India
| | - Riti Agarwal
- Department of Pathology, Max Superspeciality Hospital, Saket, New Delhi, 110017, India
| | - Bharat Aggarwal
- Department of Radiology, Max Superspeciality Hospital, Saket, New Delhi, 110017, India
| |
Collapse
|
2
|
Ganipisetti VM, Bollimunta P, Dudiki N. Spontaneous Biloma With a Hepatic Mass. Cureus 2023; 15:e40249. [PMID: 37440803 PMCID: PMC10334684 DOI: 10.7759/cureus.40249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
We report a case of an 86-year-old Hispanic male who presented with generalized itching and jaundice. Computed tomography (CT) imaging revealed a hepatic mass and an extensive spontaneous biloma, a condition rarely associated with malignancy. Subsequent biopsy of the mass confirmed moderately differentiated adenocarcinoma of the pancreaticobiliary tract. The patient underwent successful percutaneous drainage of the biloma and was discharged with a plan for further outpatient management. This case study highlights a rare manifestation of spontaneous biloma related to malignancy, broadening the clinical understanding of its association with malignancy, diagnosis, and management.
Collapse
Affiliation(s)
| | | | - Natasha Dudiki
- Pulmonary and Critical Care, Indiana University Health Ball Memorial Hospital, Muncie, USA
| |
Collapse
|
3
|
Oyama K, Iwagami Y, Kobayashi S, Sasaki K, Yamada D, Tomimaru Y, Akita H, Noda T, Asaoka T, Nakahira S, Gotoh K, Takahashi H, Tanemura M, Doki Y, Eguchi H. A Ruptured Mucinous Cystadenocarcinoma of the Pancreas Extensively Evaluated Before and After the Rupture: A Case Report. Pancreas 2023; 52:e163-e167. [PMID: 37523608 DOI: 10.1097/mpa.0000000000002198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
ABSTRACT Pancreatic mucinous cystic neoplasm (MCN) rarely ruptures because of their surrounding fibrotic capsules and has never been reported with detailed information regarding prerupture and postrupture states. We report a case of MCN rupture where performed emergency surgery was performed while waiting for elective surgery. A 54-year-old woman was referred to our department for a pancreatic cystic tumor with slight abdominal pain. A cystic tumor with a nodular lesion was found, with a contrast effect measuring 78 mm in diameter. On day 21, the patient visited our hospital complaining of increased abdominal pain, but few signs of peritonitis were observed. Tests conducted revealed moderate ascites, marginal shrinkage of the cyst diameter, and a slight elevation of inflammatory markers. We suspected an MCN rupture and immediately performed distal pancreatectomy. Brown turbid ascites and rupture of the anterior wall of the cyst were observed. In the ascites, amylase levels were not elevated, and bacterial cultures were negative. The histopathological diagnosis was noninvasive mucinous cystadenocarcinoma. At 9 months after surgery, she started chemotherapy because of a recurrence of the peritoneal dissemination. This case provided valuable insight into the rupture of MCNs using thorough imaging techniques, laboratory, and physical findings before and after rupturing.
Collapse
Affiliation(s)
- Keisuke Oyama
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Yoshifumi Iwagami
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Shogo Kobayashi
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Kazuki Sasaki
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Daisaku Yamada
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Yoshito Tomimaru
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Hirofumi Akita
- Department of Gastroenterological Surgery, Osaka International Cancer Institute
| | - Takehiro Noda
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | | | - Shin Nakahira
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Kunihito Gotoh
- Department of Gastroenterological Surgery, National Hospital Organization Osaka National Hospital
| | - Hidenori Takahashi
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | | | - Yuichiro Doki
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| | - Hidetoshi Eguchi
- From the Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University
| |
Collapse
|
4
|
Giant Abdominal Cyst Caused by Intraductal Papillary Neoplasm of the Bile Duct. J Gastrointest Surg 2023; 27:197-198. [PMID: 36127554 DOI: 10.1007/s11605-022-05447-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 02/01/2023]
|