Chandrasinghe Pramodh C, Liyanage Chandika, Deen Kemal Ismail, Wijesuriya Suraj Ruwan
Department of Surgery, University Surgical Unit, North Colombo Teaching Hospital, Ragama, Sri Lanka.
J Med Case Rep. 2013 Dec 30;7:278. doi: 10.1186/1752-1947-7-278.
Mucinous cystadenoma of the liver is a rare (less than 5%) neoplasm. This condition is more common in young women and accounts for non-specific symptoms. Cyst adenomas commonly affect the intrahepatic system (90%) and are rarely found in the extrahepatic biliary system or affecting both the systems.
A 39-year-old Sinhalese woman presented with features of obstructive jaundice and was found to have a biliary neoplasm on imaging. In the absence of a definitive diagnosis despite extensive imaging she underwent preoperative endoscopic biliary drainage followed by a left hemihepatectomy with Roux-en-Y hepaticojejunostomy. A pathological examination of the specimen revealed an obstruction of the bile duct caused by a biliary mucinous cystadenoma affecting both the intrahepatic and extrahepatic systems.
Biliary mucinous cystadenoma rarely present with obstructive jaundice affecting both intrahepatic and extrahepatic ducts. Exhaustive investigation might not help in the diagnosis and may need to be treated based on clinical judgment. The definitive treatment modality is surgery due to its malignant potential. The operative procedure is technically demanding and is best performed at specialist centers to minimize complications.
肝脏黏液性囊腺瘤是一种罕见的（不到5%）肿瘤。这种情况在年轻女性中更为常见，且症状不具特异性。囊腺瘤通常累及肝内系统（90%），很少见于肝外胆管系统或同时累及两个系统。
一名39岁的僧伽罗族女性出现梗阻性黄疸症状，影像学检查发现有胆管肿瘤。尽管进行了广泛的影像学检查仍未明确诊断，她接受了术前内镜下胆管引流，随后进行了左半肝切除术及 Roux-en-Y 肝空肠吻合术。标本的病理检查显示，胆管梗阻是由一个累及肝内和肝外系统的胆管黏液性囊腺瘤引起的。
胆管黏液性囊腺瘤很少表现为累及肝内和肝外胆管的梗阻性黄疸。详尽的检查可能无助于诊断，可能需要根据临床判断进行治疗。由于其具有恶性潜能， definitive治疗方式是手术。手术操作技术要求高，最好在专科中心进行，以尽量减少并发症。
