Biliary cystadenoma

Case contributed by Dr Ammar Ashraf

Presentation

Pain right hypochondrium radiating to the back off and on for one year. No fever or bowel/urinary symptoms.

Patient Data

Age: 35 years
Gender: Female

A well-defined cystic structure measuring approximately 5 x 9 cm is seen between the right lobe of the liver and upper pole of the right kidney. Multiple tiny echogenic foci/debris are seen in it. No calcifications, septations, solid component or internal vascularity is seen in it.    

A well-defined cystic lesion measuring 9 x 7 x 5 cm, having an average density of 8 HU, is seen between the liver and the right kidney. No septations, calcifications, solid component or enhancement is seen in it. It has a distinct interface between the liver and the kidney; however, it is slightly compressing the right kidney. A small well-defined hypodense lesion measuring about 1 cm is seen in the posterior uterine wall which is likely a uterine leiomyoma.

Case Discussion

Procedure: Laparoscopic excision of the retroperitoneal cyst.

Gross Description: Specimen submitted in a container, in formalin, labeled " cyst" consists of a single open cystic structure measuring 7 x 5 cm. The outer surface is smooth and glistening. Upon opening, the thickness of the wall is 0.1 cm. It is unilocular cyst filled with clear fluid. No solid component is identified in it.

Diagnosis: Biliary cystadenoma. No dysplasia is identified.

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