Mucinous cystic neoplasm of the liver mimicking a hydatid cy
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Mucinous cystic neoplasm of the liver is a rare slow growing lesion accounting for less than 5% of all hepatic cystic neoplasms. Differential diagnosis from other cystic lesions remains challenging despite progress achieved in the radiological modalities. Only a histopathological examination of the surgical specimen establishes with certainty the diagnosis.

A 40 year old female patient with a past medical history of hypothyroidism, presented with a 4 month history of right upper quadrant pain and weight loss. Abdominal computed tomography scan revealed a 73.75 × 48.38 mm unilocular cystic mass in the right hepatic lobe suggestive of a hydatid cyst. Laboratory tests were within normal limits. Tumor markers (including CA19–9) and serum IgE level were not performed.

Given her history of proximity to livestock in an endemic area, the diagnosis of a hydatid cyst was strongly favored. However, echinococcosis serology was negative. The patient underwent a right hepatectomy through a right subcostal incision. Grossly, the cystic mass was surrounded by a thick whitish capsule and contained a clear mucinous fluid. Histological examination demonstrated a cystic lesion lined by a columnar biliary type epithelium overlying dense spindled ovarian type stroma. There were signs of cytological atypia or mitoses. The final pathological diagnosis was mucinous biliary cystadenoma of the liver. The postoperative course was uneventful. At present, the patient is still being followed up.

Source:https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.3575
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