Case Report: Incidentally Discovered a Rare Cystic Lesion of Liver: Multicystic Biliary Hamartoma.

Wentao Mu,Shanglei Ning,Peng Su

doi:10.3389/pore.2021.628323

Wentao Mu, Shanglei Ning + Show 1 more

Open Access

https://doi.org/10.3389/pore.2021.628323

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Abstract

Multicystic biliary hamartoma (MCBH) is an extremely rare cystic lesion of the liver. A 37-year old male patient was admitted to our hospital for incidentally discovered hepatic cystic lesions on abdominal ultrasonography. Abdominal contrast-enhanced computed tomography (CT) showed a multilocular cystic lesion in the segment VI, with mild enhancement in the septae and peripheral wall within the lesion. Only alanine transaminase (ALT) and carbohydrate antigen 19–9 (CA19–9) increased slightly above normal value. Preoperative tests suggested possibility of a benign mucinous cystic neoplasm (MCN) or intraductal papillary neoplasm of the bile duct (IPNB). Laparoscopic complete resection of the lesion was performed. Histopathological examination showed numerous variably sized ductal structures surrounded by periductal glands and fibrous connective tissues containing small blood vessels and smooth muscle bundles. Immunohistochemical staining (IHC) revealed that dilated ducts were positive for cytokeratin CK19, characteristic for biliary tract. Histopathological findings confirmed diagnosis of multicystic biliary hamartoma (MCBH). No recurrence occurred during 6 months follow-up. In conclusion, MCBH should be differentiating from hepatic cystic lesion and could be resected laparoscopically safely.

Highlights

Multicystic biliary hamartoma (MCBH) is a very rare cystic lesion of the liver and its pathological features were first described in 2005
In this report we present the first case of MCBH fully resected by laparoscopic surgery
Small calcification was found on precontrast computed tomography (CT) (Figure 1A) and the septa and peripheral wall within the cystic lesion showed mild enhancement on postcontrast (Figure 1B). Based on these imaging results, we suspected that the lesion could be mucinous cystic neoplasm (MCN) or intraductal papillary neoplasm of the bile duct (IPNB) of the liver before operation

Summary

INTRODUCTION

Multicystic biliary hamartoma (MCBH) is a very rare cystic lesion of the liver and its pathological features were first described in 2005. A 37-year old male patient was found to have a multicystic mass with the size 7.7*5.6 cm in the right hepatic lobe incidentally on abdominal ultrasonography. Small calcification was found on precontrast CT (Figure 1A) and the septa and peripheral wall within the cystic lesion showed mild enhancement on postcontrast (Figure 1B). Based on these imaging results, we suspected that the lesion could be mucinous cystic neoplasm (MCN) or intraductal papillary neoplasm of the bile duct (IPNB) of the liver before operation. After the surgery serum CA19–9 level dropped to normal range (28 U/mL) and there were no signs of recurrence 6 months after surgery

DISCUSSION

15 Present case

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