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\begin{document}

\title{MUCINOUS BILIARY CYSTADENOMA OF THE LIVER MIMICKING A HYDATID CYST}



\author[1]{F. Limaiem}%
\author[1]{saadia bouraoui}%
\affil[1]{University Hospital Center Mongi Slim}%


\vspace{-1em}



  
  \date{June 16, 2024}


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\selectlanguage{english}
\begin{abstract}
Mucinous cystic neoplasm of the liver is a rare slow-growing lesion
accounting for less than 5\% of all hepatic cystic neoplasms.
Differential diagnosis from other cystic lesions remains challenging
despite progress achieved in the radiological modalities. Only
histopathological examination of the surgical specimen establishes with
certainty the diagnosis.%
\end{abstract}%



\sloppy


\textbf{CLINICAL IMAGE}

A 40-year-old female patient with a past medical history of
hypothyroidism, presented with a four-month history of right upper
quadrant pain and weight loss. Abdominal computed tomography scan
revealed a 73.75 x 48.38 mm unilocular cystic mass in the right hepatic
lobe suggestive of hydatid cyst (Fig. 1A). Laboratory tests were within
normal limits. Tumor markers (including CA19--9) and serum IgE level
were not performed. Given her history of proximity to livestock in an
endemic area, the diagnosis of a hydatid cyst was strongly favored.
However, echinococcosis serology was negative. The patient underwent a
right hepatectomy through a right subcostal incision. Grossly, the
cystic mass was surrounded by a thick whitish capsule and contained a
clear mucinous fluid (Fig 1B). Histological examination demonstrated a
cystic lesion lined by a columnar biliary type epithelium overlying
dense spindled ovarian type stroma (Figures 1C and 1D). There were signs
of cytological atypia or mitoses. The final pathological diagnosis was
mucinous biliary cystadenoma of the liver. The postoperative course was
uneventful. At present, the patient is still being followed up.

\subsubsection*{}

{\label{section}}

\subsubsection*{CONFLICT OF INTEREST
STATEMENT}

{\label{conflict-of-interest-statement}}

None declared.

\textbf{AUTHORS CONTRIBUTIONS}

Dr Faten LIMAIEM prepared, organized, wrote, and edited all aspects of
the manuscript. She performed the gross and microscopic pathologic
evaluation of the pathology specimen. She prepared all of the histology
figures in the manuscript. She read, edited, and approved the final
version of the manuscript. Pr Saadia BOURAOUI participated in the
drafting of the article and revising it critically for important
intellectual content,

\textbf{ACKNOWLEDGEMENT STATEMENT}

I would like to offer my special thanks to Mrs Sa\selectlanguage{ngerman}ïda Jerbi who prepared
the microscopic slides.

\textbf{REFERENCES}

{[}1{]} Zen Y, Pedica F, Patcha VR , Capelli P, Zamboni G, Casaril A.
2011. Mucinous cystic neoplasms of the liver: a clinicopathological
study and comparison with intraductal papillary neoplasms of the bile
duct. Modern Pathology 24: 1079-89.

{[}2{]} Averbukh LD, Wu DC,~ Cho WC, Wu GY. 2019. Biliary Mucinous
Cystadenoma: A Review of the Literature. J Clin Transl Hepatol 28; 7(2):
149-53.

{\label{averbukh-ld-wu-dc-cho-wc-wu-gy.-2019.-biliary-mucinous-cystadenoma-a-review-of-the-literature.-j-clin-transl-hepatol-28-72-149-53.}}

\textbf{FIGURE LEGENDS:}

\textbf{MULTIPANEL FIGURE LEGEND:}

\textbf{Figure 1A} : Axial CT scan demonstrating a unilocular cystic
mass within the right hepatic lobe of the liver, measuring 73.75 x 48.38
mm.

\textbf{Figure 1B:} Macroscopic findings of mucinous cystadenoma. A
unilocular well-delineated cystic mass of the liver surrounded by a
thick fibrous capsule.

\textbf{Figure 1C:} Solitary cystic lesion of the liver lined by simple
epithelium overlying ovarian type stroma (Hematoxylin and eosin,
magnification × 40).

\textbf{Figure 1D:} Histological examination of the hepatic cyst showing
columnar biliary type epithelium overlying dense spindled ovarian type
stroma (Hematoxylin and eosin, magnification × 400).\selectlanguage{english}
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\includegraphics[width=0.70\columnwidth]{figures/Figure-1-TIFF/Figure-1-TIFF}

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\end{figure}

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