A CASE OF A CYSTIC TUMOR OF THE LIVER WITH CANCEROUS CHANGE PRESUMABLY ARISEN FROM A HEPATIC CYST DURING THE SIX FOLLOW-UP YEARS

Abstract

We report a case of a cystic tumor of the liver with cancerous change presumably arisen from a hepatic cyst of the caudate lobe that had been followed for about six years. A 76-year-old male who had been followed for a hepatic cyst elsewhere since 1996 was referred to our hospital in January 2003 because abdominal CT scan demonstrated a solid component within the hepatic cyst. Abdominal CT scan showed a solid component within a 4.5-cm cyst in the caudate lobe of the liver. Endoscopic retrograde cholangiography showed communication between the duct in the left hepatic lobe and the cystic lesion. Fine -needle aspiration of the cystic lesion was conducted under ultrasonography and the cytological diagnosis was class V. An extended left lobectomy with caudate lobectomy was performed under a diagnosis of cystic tumor with cancerous change arisen from a hepatic cyst. On gross examination of the resected specimen, a 2-cm solid projection was present in a 5.2-cm cystic lesion. Pathologically high columnar atypical epithelial cells proliferated in a papillary form in the cystic wall and the solid component was composed of well differentiated adenocarcimoma. The patient is alive bearing multiple liver metastases and para-aortic lymph node metastasis 3 years and 1 month after the surgery.
It is very important to detect every small change in hepatic cysts early by abdominal ultrasonography and CT scan, because the hepatic cystic have a potential to degenerate into cystic tumor with cancerous change.