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肝脏中酷似包虫囊肿的黏液性囊性肿瘤:两例罕见病例。

Musinous cystic neoplasia mimicking hydatid cyst in the liver: Two rare cases.

作者信息

Tekin Emel, Taşkın Toros, Ayhan Semin

机构信息

Department of Pathology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Türkiye.

Clinic of Pathology, Celal Bayar University Hafsa Sultan Hospital, Manisa, Türkiye.

出版信息

Turk J Surg. 2024 Mar 23;40(1):82-86. doi: 10.47717/turkjsurg.2022.4805. eCollection 2024 Mar.

Abstract

Mucinous cystic neoplasm of the liver (MCN-L) is a rare tumor which accounts for less than 5% of all liver cysts. Although they are considered to be "benign cysts" radiologically and clinically because of their slow growth, they are considered as premalignant. We present two radiologically misdiagnosed cases that operated in a short time range, in order to increase awareness for these rare tumors. A 47-year-old female patient who had no active complaints 58 x 40 mm cystic lesion was detected in the liver, which was diagnosed hydatid cyst radiologically. The pathological examination showed multiloculated cysts which was covered by low-grade mucinous epithelium and ovarian-type stroma on the cyst wall. A 50-year-old female patient presented with abdominal distention. The radiographical screening revealed a 204 x 140 mm cystic lesion that completely fills left lobe of liver which interpreted in favor of hydatid cyst. Histopathologically, the inner surface of the cyst was covered with low grade mucinous epithelium. Ovarian-type stroma was detectable only by immunohistochemistry due to significant bleeding and edema on the wall. The diagnosis of both of our cases was low grade MCN-L. Since cysts were not intact at the time of gross examination, we could not make any comment about surgical margins or total excision. MCN-L is a tumor that creates difficulty in presurgical differential diagnosis because of its rarity and lack of specific radiologic features. Although the prognosis is excellent as a result of total excision in the benign group, relapses have also been reported.

摘要

肝脏黏液性囊性肿瘤(MCN-L)是一种罕见肿瘤,占所有肝囊肿的比例不到5%。尽管由于其生长缓慢,在放射学和临床上被认为是“良性囊肿”,但它们被视为癌前病变。我们呈现两例在短时间内接受手术的放射学误诊病例,以提高对这些罕见肿瘤的认识。一名47岁女性患者,无明显不适,肝脏内检测到一个58×40mm的囊性病变,放射学诊断为包虫囊肿。病理检查显示为多房性囊肿,囊肿壁被低级别黏液上皮和卵巢型间质覆盖。一名50岁女性患者因腹胀就诊。影像学筛查发现一个204×140mm的囊性病变,完全占据肝脏左叶,考虑为包虫囊肿。组织病理学检查显示,囊肿内表面被低级别黏液上皮覆盖。由于囊肿壁有明显出血和水肿,仅通过免疫组化可检测到卵巢型间质。我们两例患者的诊断均为低级别MCN-L。由于大体检查时囊肿不完整,我们无法对手术切缘或完整切除情况作出任何评价。MCN-L是一种肿瘤,因其罕见性和缺乏特异性放射学特征,在术前鉴别诊断中存在困难。尽管良性组完全切除后预后良好,但也有复发的报道。

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