The management of a cystic hepatic lesion ruptured in the bile ducts: a case report

J Med Case Rep. 2017 Jun 16;11(1):159. doi: 10.1186/s13256-017-1329-9.

Abstract

Background: Hepatic cystadenoma is a rare benign cystic tumor; it tends to recur after incomplete surgical resection and has malignant potential. We report the case of a patient with a ruptured biliary cystadenoma in the common bile duct that caused diagnostic and therapeutic problems.

Case presentation: A 34-year-old North African woman, admitted for angiocholitis, was operated 2 months before for a hepatic cystic lesion taken for a hydatid cyst compressing her common bile duct. The clinical and the complementary examinations converged toward recurrence of the hydatid cyst for which a surgical resection was decided. Intraoperative findings as well as the histological study of the "membranes" extracted from her common bile duct indicated a hepatic cystadenoma.

Conclusions: The rarity of hepatic cystadenoma and the non-specificity of clinical and imaging signs make diagnosis of hepatic cystadenoma difficult, especially when it is complicated by rupture in the bile ducts; this contributes to a delay in diagnosis and an inadequate therapeutic approach.

Keywords: Biliary cystadenoma; Biliary tract; Obstructive jaundice.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / pathology
  • Bile Duct Neoplasms / surgery
  • Bile Ducts / diagnostic imaging
  • Bile Ducts / pathology*
  • Cholangiography
  • Cystadenoma / diagnosis*
  • Cystadenoma / diagnostic imaging
  • Cystadenoma / pathology
  • Cystadenoma / surgery
  • Female
  • Humans
  • Jaundice, Obstructive / diagnosis
  • Jaundice, Obstructive / etiology
  • Jaundice, Obstructive / pathology
  • Jaundice, Obstructive / surgery
  • Rare Diseases
  • Rupture, Spontaneous / diagnostic imaging
  • Rupture, Spontaneous / pathology*
  • Rupture, Spontaneous / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome