Siriwardana Pulathis N, Pathirana Aloka
J Med Case Rep. 2009 Sep 8;3:9032. doi: 10.4076/1752-1947-3-9032.
Biliary cystadenoma is a rare, benign neoplasm of the bile ducts with malignant potential. Symptoms, predominantly right hypochondrial pain and the feeling of a lump or fullness are usually due to the mass effect. Jaundice is rare. This is the fifth reported patient with an intrahepatic biliary cystadenoma giving rise to episodic biliary obstruction, which is usually caused by choledocholithiasis or periampullary carcinoma. Considering the mean age of previous similar patients (53.5, standard deviation 14.6 years), the early age of presentation is very unusual in our patient.
A 25-year-old Asian woman presented with right hypochondrial pain and episodic biliary obstruction. Contrast enhanced computed tomography revealed a cystic mass in segment 4B and protruding into and along the left hepatic duct. Laparotomy confirmed the contrast enhanced computed tomography findings and histology revealed an intrahepatic mucinous biliary cystadenoma.
Biliary cystadenoma should be considered as a differential diagnosis in patients with cystic liver lesions who present with episodic biliary obstruction. Due to the reported malignant potential, radical surgery such as wide local excision of the lesion or hepatic resection is needed to minimize the risk of local recurrence.
胆管囊腺瘤是一种罕见的胆管良性肿瘤，具有恶变潜能。症状主要为右季肋部疼痛以及肿块感或饱胀感，通常是由肿块效应引起。黄疸较为少见。这是第五例报告的肝内胆管囊腺瘤导致发作性胆管梗阻的患者，发作性胆管梗阻通常由胆总管结石或壶腹周围癌引起。考虑到之前类似患者的平均年龄（53.5岁，标准差14.6岁），我们的患者发病年龄较早，情况非常罕见。
一名25岁的亚洲女性出现右季肋部疼痛和发作性胆管梗阻。增强计算机断层扫描显示肝4B段有一个囊性肿块，并突入左肝管并沿其走行。剖腹手术证实了增强计算机断层扫描的结果，组织学检查显示为肝内黏液性胆管囊腺瘤。
对于出现发作性胆管梗阻的肝囊性病变患者，应将胆管囊腺瘤作为鉴别诊断之一。鉴于其有恶变潜能的报道，需要进行根治性手术，如病变的广泛局部切除或肝切除术，以降低局部复发风险。
