Srinivas Teerthanath, Bhat Shubha P, Sunder Geoffrey, Sivarajan Ranjith
Department of Pathology, K S Hegde Medical Academy, Nitte University, Mangalore, Karnataka India.
Indian J Surg Oncol. 2020 Sep;11(Suppl 2):204-207. doi: 10.1007/s13193-020-01121-7. Epub 2020 Jun 12.
Mucinous cystic neoplasms of the liver involving the extrahepatic biliary tract is a rare slow-growing benign neoplasm of biliary system that has an early clinical presentation with obstructive jaundice. These tumors have a high risk of malignant transformation, which is difficult to diagnose preoperatively by radiology or endoscopy. We present a 31-year-old female patient who presented with complaints of pain abdomen, vomiting, fever, and obstructive jaundice. Ultrasound abdomen showed features suggestive of cholangitic abscess. Computed tomography abdomen showed features suggestive of cholangitic abscess and abrupt termination of the proximal CBD secondary to the stricture. A left hemi-hepatectomy was performed which showed a multiloculated cystic liver lesion with the involvement of extrahepatic duct, cystic duct, and proximal common bile duct. Histopathology showed cyst was lined by mucin secreting columnar epithelium without nuclear atypia, the wall the cysts showed ovarian-like stroma, and the diagnosis of mucinous cystic neoplasms of the liver and extrahepatic biliary tract with ascending cholangitis was made. Regular follow-up by clinical and radiological examination at 6 months did not reveal any recurrence.
累及肝外胆道的肝脏黏液性囊性肿瘤是一种罕见的生长缓慢的胆道良性肿瘤,早期临床表现为梗阻性黄疸。这些肿瘤有恶变的高风险,术前通过放射学或内镜检查难以诊断。我们报告一名31岁女性患者,主诉腹痛、呕吐、发热和梗阻性黄疸。腹部超声显示提示胆管脓肿的特征。腹部计算机断层扫描显示提示胆管脓肿的特征以及由于狭窄导致肝总管近端突然中断。实施了左半肝切除术,结果显示为多房性囊性肝病变,累及肝外胆管、胆囊管和肝总管近端。组织病理学显示囊肿内衬分泌黏液的柱状上皮,无核异型性,囊肿壁显示卵巢样间质,诊断为累及肝外胆道的肝脏黏液性囊性肿瘤伴上行性胆管炎。6个月时通过临床和放射学检查进行定期随访未发现任何复发。