Biliary
cystadenomas are rare
tumors of the bile ducts most commonly presenting as large right liver lobe lesions. These are usually slow-growing and mostly benign. They commonly present with
abdominal pain. On physical exam an abdominal mass can be identified occasionally. Walls of biliary
cystadenomas appear thicker than simple
cysts, with soft tissue nodules and enhancing septations on CT or MRI. Radiographic images can vary with the amount of
protein content in the fluid on CT or MRI. Due to the risk of malignant transformation, complete surgical resection is advised. Hereby, we describe a 37-year-old lady who presented to the outpatient clinic with bloating and abdominal discomfort with intermittent elevated liver
enzymes and
hyperbilirubinemia. Ultrasound of the liver and bile ducts followed by CT scan and magnetic resonance cholangiopancreatography confirmed the presence of biliary
cystadenoma of the intra- and extrahepatic ducts. It was seen as a filling defect of the intra- and extrahepatic ducts (common hepatic duct) on endoscopic retrograde cholangiopancreatography. Involvement of the intra- and extrahepatic bile ducts simultaneously is a rare presentation of this
tumor. She later on underwent exploratory
laparotomy with extrahepatic bile duct resection, left hepatic lobe resection and reconstruction with hepaticojejunostomy. Pathology confirmed the presence of biliary
cystadenoma with ovarian-like stroma. She had recovered uneventfully from the surgery when seen 2 weeks later in the clinic. Biliary
cystadenoma is a rare, mostly
benign neoplasm of the biliary tract that should be considered in the differential diagnosis of cystic lesions of the biliary tract.