Extended liver resection in a central biliary cystadenoma

Abstract

Objective: Biliary cystoadenomas are rare, less than 5% of non-parasitic liver cysts and often confused with other more common cystic disease. Its premalignant potential indicates the need for a complete surgical resection. Video presentation of a central cystadenoma with bilateral vascular relations. Methods: 61 year old female with a cystic tumor involving segments 3,4b,5,7 and 8; diagnosed 5 years ago and followed up by ultrasound with slow growth. CT: multilocular cyst that compress bilaterally elements of hepatic hilum. MRI: 13 cm centrally located tumor extending cephalic from the liver caudate lobe to the dome, hypointense in T1, hyperintense in T2; in contact with pancreatic head and bilateral hepatic highland displacement. Results: Right extended hepatectomy was performed with good postoperative evolution. Discharge at 5th day. Pathology: mucinous cystic neoplasm of the liver with low-grade dysplasia, negative margins. Conclusion: Complete resection is the best treatment for biliary cystadenoma in order to avoid recurrence and malignant transformation. According to the anatomical location, the parenchymal characteristics and the liver remnant the best approach for a complete resection needs to the considered. Partial resections must be avoided.