A CASE REPORT OF HAMARTOMATOUS HEPATIC CYST PREOPERATIVELY DIAGNOSED AS CYSTADENOCARCINOMA

Abstract

With a recent development of abdominal ultrasonography, we have increasingly experienced hepatic cysts routinely, but malignant hepatic cysts are rare which present extreme difficulty in differential diagnosis. A diagnosis of cystadenocarcinoma is often made by postoperative histopathological examination. We present a case suspected of cystadenocarcinoma of the liver which was eventually diagnosed as hamartomatous cyst after operation, with a review of the literature.
A 72-year-old woman was admitted to the hospital for close examination of a hepatic cystic lesion with septa, detected by accidental computed tomography. Abdominal ultrasonography showed a large multilocular cyst of 8cm in diameter in the right lobe of the liver. Septa with partial calcification and papillary tumors protruding into the cavity were also seen. US guided aspiration cytology and biopsy did not show any malignant cells, however, elevated CEA (101ng/ml) and CA19-9 (120000U/ml) in the cyst fluid led us to the diagnosis of cystadenocarcinoma. Extended lobectomy of the right lobe was carried out. Resected specimen contained grayish debris, however, neither solid mass nor papllary protruding tumors were recognized. Histopathological diagnosis was hamartomatous cyst and no malignant lesions were demonstrated. Immunohistochemical staining with CEA was negative.