A cystic, septated lesion in the liver with unusual diagnosis.

Abstract

A 51-year-old male patient from Iraq presented with symptoms of right upper-quadrant abdominal pain. Imaging showed a 9 cm, lobulated cystic lesion in the right liver lobe with thin septations, suggestive of a hydatid cyst. Although serology for hydatid disease was negative, the cystic lesion was treated by percutaneous drainage. Owing to persisting symptoms, he was re-evaluated showing the same cystic lesion unchanged. On the presumptive diagnosis of a cystadenoma or cystadenocarcinoma, patient underwent laparotomy. A solitary, cystic lesion was found that was removed by local excision. Macroscopical examination revealed a multilocular, septated tumour. Histopathological assessment showed lining of the cysts with epithelioid cells that showed immunohistochemical features consistent with a mesothelial origin; the pathology findings are consistent with an adenomatid tumour; in the differential diagnosis a benign multicystic mesthelioma was also considered. These are rare cystic lesions in the liver of which only few cases have been described in literature.

• Authors: Iteke van Seventer, Joanne Verheij, Saffire Phoa, Thomas M van Gulik
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2014 (Oct 28 2014) ISSN: 1757-790X [Electronic] England
• PMID: 25352388 (Publication Type: Case Reports, Journal Article)
• Copyright: 2014 BMJ Publishing Group Ltd.

Topics

• Abdominal Pain (etiology)
• Adenomatoid Tumor (complications, diagnosis, surgery)
• Cysts (diagnostic imaging, surgery)
• Diagnosis, Differential
• Humans
• Iraq
• Liver (diagnostic imaging, surgery)
• Liver Neoplasms (complications, diagnosis, surgery)
• Male
• Middle Aged
• Tomography, X-Ray Computed (methods)
• Ultrasonography