Abstract
We present here a case of chylous cyst of liver with multiple cysts in mesentry, in a 14-year-old. A 14-year-old female presented in surgical outpatient unit with gradual swelling of abdomen for five months without any history of fever, jaundice, trauma or previous operation. Ultrasound and contrast enhanced computed tomography scan suggested a large multiseptate space occupying hypodense lesion. On laparotomy, a huge lobulated cyst containing clear fluid was found arising from left lobe of liver extending up to pelvis. Multiple small cysts were present in mesentery, mesoappendix and serosa of gallbladder. The giant cyst was excised completely with cystic left lobe of liver. Histopathology suggested chylous cyst of liver. There is no recurrence after two years of follow-up. We conclude that patient had chylous cysts at multiple places with largest from liver.
Highlights
We present here a case of chylous cyst of liver with multiple cysts in mesentry, in a 14-year-old female
Ultrasonography and contrast enhanced computed tomography (CT) scan suggested a fairly large multiseptate space occupying lesion of size 20x12 cm in relation to left lobe of liver, abutting the liver and pancreas, with impression of resolving liver abscess or pancreatic pseudocyst (Figure 2)
Histopathological report was cystic lesion lined by flattened endothelium, the cyst wall composed of fibrocollagenous tissue infiltrated with lymphocytes with impression of chylous cyst of liver, gallbladder wall infiltrated by chronic inflammatory cells and appendix showed lymphoid hyperplasia
Summary
In 1842, von Rokitansky described a chylous mesenteric cyst. Since a few reports of chylous cysts are reported. We present here a case of chylous cyst of liver with multiple cysts in mesentry, in a 14-year-old female. This may be a first reported giant chylous cyst of liver. On opening the peritoneum a huge lobulated cyst with clear content was found arising from the left lobe of liver extending up to pelvis (Figure 3). Histopathological report was cystic lesion lined by flattened endothelium, the cyst wall composed of fibrocollagenous tissue infiltrated with lymphocytes with impression of chylous cyst of liver, gallbladder wall infiltrated by chronic inflammatory cells and appendix showed lymphoid hyperplasia. After the operation the patient remained asymptomatic and there was no development of any detectable cyst on ultrasonography or recurrence in liver after two years on follow-up
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