Abstract
A 63-year-old man was seen at the hospital because of epigastralgia. Physical examination revealed an elastic soft and smooth mass with tenderness in the hypogastrium. Laboratory findings and tumor markers were in the normal range. Abdominal ultrasonogram and CT scan revealed a cystic and partially solid lesion in the lateral segment of the liver. In the solid portion, enhanced CT revealed an enhancement, and angiography demonstrated interruption of arterioles and accumulation of contrast material. The hepatic duct was not connected to the cyst on ERCP. With a diagnosis of biliary cystadenocarcinoma, an operation was performed. The lesion did not invade the hepatic parenchyma and could be removed by a lateral segmentectomy. The cyst contained clear mucinous fluid and a papillary projection with hemorrhage was found. Histopathologically, this lesion was considered to be biliary cystadenocarcinoma derived from a simple cyst, because a transitional portion was found between atypical cells in the papillary projection and cuboidal cells of the cyst wall.
