Hepatic cystadenoma

Case contributed by Saúl Uriel Mijarez Banda
Diagnosis probable

Presentation

Incidental finding on USG two months ago. There are no relevant symptoms or signs.

Patient Data

Age: 65 years
Gender: Female
mri
This study is a stack
Axial T2 HASTE
fat sat
This study is a stack
Coronal T2
TRUFI cor
Coronal
MRCP-Thick Slab
This study is a stack
Axial T1 VIBE
C+ fat sat
This study is a stack
Sagittal T1
VIBE C+ fat sat
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Info

The liver has normal morphology and size. In segment IV, adjacent to the hilium, a well-defined complex rounded cystic image is identified, it shows low signal intensity on T1WI and high intensity on T2WI, it presents a defined wall with multiple internal septa up to 2 mm thick, which enhances with gadolinium-based contrast medium, showing "cyst within a cyst" appearance. There are no solid nodular or papillary components, it measures 3 x 4.5 x 4 cm.

The bile ducts do not show dilation, and no lymphadenopathy is observed.

Case Discussion

Biliary cystadenomas typically present in middle-aged female patients, with symptoms mainly associated with their size and location 1. Its classic appearance is a complex, single cystic lesion, with the presence of thin septa and progressive contrast enhancement, while the presence of thick septa and internal nodular components and an irregular stroma suggests cystadenocarcinoma, however there is considerable overlap 1-4.

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