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.
CONFLICT OF INTEREST
STATEMENT
None declared.