Beard Rachel E, Yee Eric U, Mortele Koenraad J, Khwaja Khalid
Department of Surgery, Beth Israel Deaconess Medical Center, 110 Francis Street, Boston, MA 02215, United States.
Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, United States.
Int J Surg Case Rep. 2014;5(12):919-23. doi: 10.1016/j.ijscr.2014.10.014. Epub 2014 Oct 17.
Multicystic biliary hamartoma is a rare liver tumor that was first described in 2005. Only nine cases are reported in the literature and all of them originate from Eastern patient populations, specifically Japan and Korea.
Herein we report the occurrence of the tenth multicystic biliary hamartoma reported to date, arising in a Caucasian American woman initially presenting with abdominal pain. At 4.7cm this is the second largest tumor reported to date and the only one arising in a Western patient population.
The patient underwent multimodality imaging and the tumor was biopsied preoperatively, but the diagnosis remained unclear. An extended right hepatectomy was performed for resection of her tumor, and the tumor was definitively diagnosed based on the surgically resected specimen. As all nine of the previously reported cases also underwent resection, the natural history of this lesion remains unknown. The lack of both recurrence and tumor spread in the previously reported cases indicates that this may be a benign lesion not requiring surgical resection unless symptomatic.
Multicystic biliary hamartoma is an extremely rare tumor. Increased awareness of the radiologic and pathologic features will likely lead to the diagnoses of further cases in both Western and Eastern populations and could potentially assist with preoperative diagnosis. The natural history and optimal management of this tumor remain uncertain.
多囊性胆管错构瘤是一种罕见的肝脏肿瘤,于2005年首次被描述。文献中仅报道了9例,所有病例均来自东方患者群体,特别是日本和韩国。
在此,我们报告了迄今为止报道的第10例多囊性胆管错构瘤,发生在一名最初表现为腹痛的美国白人女性身上。该肿瘤大小为4.7厘米,是迄今为止报道的第二大肿瘤,也是唯一发生在西方患者群体中的病例。
患者接受了多模态成像检查,并在术前对肿瘤进行了活检,但诊断仍不明确。为切除肿瘤进行了扩大右肝切除术,并根据手术切除标本明确诊断。由于之前报道的9例病例也都接受了切除术,该病变的自然病程仍不清楚。之前报道的病例中既无复发也无肿瘤扩散,这表明除非有症状,否则这可能是一种无需手术切除的良性病变。
多囊性胆管错构瘤是一种极其罕见的肿瘤。提高对其影像学和病理学特征的认识可能会在西方和东方人群中发现更多病例,并可能有助于术前诊断。该肿瘤的自然病程和最佳治疗方法仍不确定。