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Jia JJ, Cheng YF, Feng MB, Liu L, Shuai MQ, Shen XD, Tang XF, Zheng SS. Diagnosis and treatment of biliary mucinous cystic neoplasms: A single-center experience. Hepatobiliary Pancreat Dis Int 2023:S1499-3872(23)00130-3. [PMID: 37652799 DOI: 10.1016/j.hbpd.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/07/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Biliary mucinous cystic neoplasms (BMCNs) are rare hepatobiliary cystic tumors, which can be divided into noninvasive and invasive types. This study aimed to investigate the diagnosis, treatment, and prognosis of BMCNs in a large single center. METHODS We analyzed 49 patients with BMCNs confirmed by postoperative pathology at the First Affiliated Hospital, Zhejiang University School of Medicine between January 2007 and December 2021. RESULTS Among the 49 patients, 37 were female (75.5%), and the average age was 57.04 years. Common symptoms included abdominal discomfort, jaundice and fever, while 22 patients (44.9%) had no symptoms. Serum carbohydrate antigen (CA) 19-9 and CA125 concentrations were elevated in 34.8% and 19.6% of patients, respectively. Forty-eight patients had tumors in the intrahepatic bile ducts and only one had a tumor in the extrahepatic bile duct. Forty-eight patients with noninvasive intrahepatic BMCNs were further analyzed in terms of pathological features: 34 (70.8%) had low-grade intraepithelial neoplasms (LGINs), and 14 (29.2%) had high-grade intraepithelial neoplasms (HGINs). The potential immunohistochemical markers of BMCNs were cytokeratin (CK) 19, CK7, estrogen receptor and progesterone receptor. Follow-up data for 37 patients with intrahepatic BMCNs were obtained. The median overall survival (OS) of BMCNs was not reached. The longest survival time was 137 months.The 5- and 10-year OS rates were 100% and 85.4%, respectively. The 5- and 10-year recurrence-free survival (RFS) rates were 93.9% and 80.2%, respectively. CONCLUSIONS BMCNs are rare cystic neoplasms that commonly occur in middle-aged females. BMCNs can only be diagnosed and classified by postoperative pathology, as there are no specific clinical presentations, serological indicators or imaging modalities for preoperative diagnosis. Complete surgical resection is necessary for BMCNs, and the postoperative prognosis is favorable.
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Affiliation(s)
- Jun-Jun Jia
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Ya-Fen Cheng
- Department of International Healthcare Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Mei-Bao Feng
- Department of Pathology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Li Liu
- Department of Library, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Ming-Qi Shuai
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Xiao-Dong Shen
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Xiao-Feng Tang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Shu-Sen Zheng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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2
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Hoti KD, Shkololli AJ, Shatri J, Hyseni F, Roy P, Maliha M, Kubra KT, Musa J, Vokshi V, Obando A, Saha T, Syed Z, Saini J, Rakovica L, Choudhary J. Biliary cystadenoma: Case report with MRI findings and surgical confirmation. Radiol Case Rep 2022; 17:3974-3978. [PMID: 35991384 PMCID: PMC9388884 DOI: 10.1016/j.radcr.2022.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/22/2022] Open
Abstract
Biliary cystadenoma is a very uncommon benign cystic neoplasm involving the liver and the biliary tract. Most common presentations include right upper quadrant pain, nausea, vomiting, obstructive jaundice, and enlarging liver size. It can mimic many more commonly occurring diseases such as hepatic cyst, hepatic abscess, hydatid disease of the liver, and hepatic tuberculosis. Hence it becomes very challenging for physicians to correctly diagnose it due to its rarity and similarity with other conditions. Furthermore, very few pieces of literature guide physicians in correctly identifying the disease. Based on his physical examination and detailed investigation, we present a case report of a 72-year-old female diagnosed with biliary cystadenoma. We hope that this case report will significantly add to the existing literature on this subject
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Affiliation(s)
- Kreshnike Dedushi Hoti
- Faculty of Medicine “Hasan Prishtina ” Clinic of Radiology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Argjira Juniku Shkololli
- Department of Pathophysiology, Clinic of Gastroenterology, University Clinical Center of Kosovo, Prishtina, Kosovo
- Corresponding author.
| | - Jeton Shatri
- Faculty of Medicine “Hasan Prishtina ” Clinic of Radiology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | | | - Pooja Roy
- Department of Laborotory Medicine and Pathology, Mayo Clinic, Rochester, USA
- Minnesota Internal Medicine Resident, Harlem Hospital Ctr, , New York, USA
| | | | | | - Juna Musa
- Department of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, USA
| | - Valon Vokshi
- Department of Anesthesiology and Reanimation, University Clinical Center of Kosovo
| | - Alejandro Obando
- Endoscopy Unit, Hospital Bautista, Managua, Nicaragua
- Surgical Unit, Hospital Vivian Pellas, Managua, Nicaragua
| | - Tias Saha
- Diabetic Association Medical College, Faridpur, Bangladesh
| | - Zaina Syed
- Biochemistry, Hunter College, CUNY. New York, USA
| | - Jasmine Saini
- Department of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, USA
| | - Loran Rakovica
- St.Barnabas Hospital, Department of Medicine, New York, USA
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3
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Dsouza C, Diaz E, Nambiar S, Pinto S. Biliary Cystadenoma — Our Experience. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Chenin M, Paisant A, Lebigot J, Bazeries P, Debbi K, Ronot M, Laurent V, Aubé C. Cystic liver lesions: a pictorial review. Insights Imaging 2022; 13:116. [PMID: 35838923 PMCID: PMC9287528 DOI: 10.1186/s13244-022-01242-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
Hepatic cysts (HC) are sac-like structures mainly filled with liquid and showing a distinct membrane. They are usually found incidentally through imaging. A wide spectrum of imaging patterns may be observed for common and uncommon, neoplastic and non-neoplastic diseases. While simple hepatic cysts occur frequently and do not require any treatment or follow-up, non-typical cysts should be carefully analysed to avoid misdiagnosing a lesion that would require appropriate management. Therefore, adequate knowledge of all the relevant imaging patterns is critical to secure an accurate diagnosis. The aim of this review is to describe the imaging features of the different types of hepatic cysts.
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Affiliation(s)
- Mégane Chenin
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France.
| | - Anita Paisant
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France.,HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| | - Jérôme Lebigot
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France.,HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
| | - Paul Bazeries
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France
| | - Kawtar Debbi
- Department of Radiology, La Timone Children Hospital of Marseille, 264 rue St Pierre, 13385, Marseille Cedex 05, France
| | - Maxime Ronot
- Department of Radiology, Beaujon Hospital, APHP.Nord, 100 boulevard du Général Leclerc, 92110, Clichy, France.,Université de Paris, Paris, France
| | - Valérie Laurent
- Department of Radiology, University Hospital of Nancy, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France
| | - Christophe Aubé
- Department of Radiology, University Hospital of Angers, 4 rue Larrey, 49 933, Angers Cedex 09, France.,HIFIH Laboratory, EA 3859, UNIV Angers, 49045, Angers, France
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5
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Tang Y, Wang C, Fu S, Li T, He G. Intrahepatic Biliary Cystadenoma With Colonic Adenomatous Polyps in a Patient With Chronic Hepatitis B: A Case Report and Literature Review. Front Med (Lausanne) 2021; 8:760607. [PMID: 34977067 PMCID: PMC8716544 DOI: 10.3389/fmed.2021.760607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/25/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Biliary cystadenomas are rare cystic tumors of the bile duct system that are mostly benign but also have the possibility of malignant transformation. Biliary cystadenomas mostly occur in the intrahepatic bile ducts and are more common in middle-aged women. Due to non-specific radiology, preoperative diagnosis is difficult and is usually performed by postoperative pathology. Complete resection is the best treatment option, and the postoperative prognosis is good.Case Description: This study reports a case of a patient with biliary cystadenoma who was diagnosed with simultaneous chronic hepatitis B and colon (hepatic flexure) adenomatous polyps. The patient presented to the doctor because of abdominal pain, and a blood test showed hepatitis B. Computed tomography revealed both right liver and colonic lesions. Colonoscopy revealed polyps, and the postoperative pathological diagnosis was adenomatous polyps. Laparoscopic resection of the right liver tumor was performed, and it was diagnosed as hepatobiliary cystadenoma by postoperative pathological analysis combined with immunohistochemistry.Conclusion: In patients with chronic hepatitis, the shape of biliary cystadenoma may not be very typical, and it is necessary to combine this with immunohistochemistry for diagnosis. When multiple lesions are detected in the painful area, the diagnosis of each lesion and its treatment sequence are worthy of consideration. Under normal circumstances, the prognosis of biliary cystadenoma is good; however, in patients with chronic hepatitis B, more cases need to be observed for verification.
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Affiliation(s)
- Yan Tang
- The Remarkable and Innovation Class, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chenyu Wang
- The Remarkable and Innovation Class, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Shunjun Fu
- Department of Hepatobiliary Surgery II, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ting Li
- Department of Hepatobiliary Surgery II, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Ting Li
| | - Guolin He
- Department of Hepatobiliary Surgery II, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Guolin He
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Shimizu T, Yoshioka M, Kaneya Y, Kanda T, Aoki Y, Kondo R, Takata H, Ueda J, Kawano Y, Hirakata A, Matsushita A, Taniai N, Mamada Y, Yoshida H. Management of simple hepatic cyst. J NIPPON MED SCH 2021; 89:2-8. [PMID: 34526451 DOI: 10.1272/jnms.jnms.2022_89-115] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Simple hepatic cysts are typically saccular, thin-walled masses with fluid-filled epithelial lined cavities that arise from aberrant bile duct cells during embryonic development. With the development of diagnostic modalities such as ultrasonography, computed tomography and magnetic resonance imaging, simple hepatic cysts are seen with relative frequency in daily clinical examination. US is the most useful and noninvasive tool for the diagnosis of simple hepatic cysts, and can generally differentiate simple hepatic cysts from abscesses, hemangiomas and malignancies. Cysts with irregular walls, septations, calcifications or daughter cysts on US should be evaluated with enhanced CT or MRI to differentiate simple hepatic cysts from cystic neoplasms or hydatid cysts.Growth and compression of hepatic cysts cause abdominal discomfort, pain, distension and dietary symptoms such as nausea, vomiting, a feeling of fullness and early satiety. Complications of simple hepatic cysts include infection, spontaneous hemorrhage, rupture, and external compression of biliary tree or major vessels.Asymptomatic simple hepatic cysts should be observed. Treatment for symptomatic simple hepatic cysts includes percutaneous aspiration, aspiration followed by sclerotherapy, and surgery. The American College of Gastroenterology clinical guidelines recommend laparoscopic fenestration based on its high success rate and low invasiveness. Percutaneous procedures for treatment of simple hepatic cysts are particularly effective for the immediate palliation of patient symptoms; however, they are not generally recommended because of the high rate of recurrence.Management of simple hepatic cysts requires correct differentiation from neoplasms and infections, and the selection of a reliable treatment.
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Affiliation(s)
- Tetsuya Shimizu
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Masato Yoshioka
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Yohei Kaneya
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Tomohiro Kanda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Yuto Aoki
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Ryota Kondo
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Hideyuki Takata
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Junji Ueda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Youichi Kawano
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Atsushi Hirakata
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Akira Matsushita
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Nobuhiko Taniai
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Yasuhiro Mamada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
| | - Hiroshi Yoshida
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School
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7
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Limaiem F, Bouraoui S. Mucinous cystic neoplasm of the liver mimicking a hydatid cyst. Clin Case Rep 2021; 9:597-598. [PMID: 33489228 PMCID: PMC7813111 DOI: 10.1002/ccr3.3575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/05/2020] [Indexed: 11/10/2022] Open
Abstract
Misdiagnosis of mucinous cystic neoplasms of the liver may have serious consequences due to their premalignant potential. A thorough understanding of their characteristic features and a high index of suspicion are mandatory (Mod Pathol, 24, 2011, and 1079).
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Affiliation(s)
- Faten Limaiem
- Tunis Faculty of MedicineUniversity of Tunis El ManarTunisTunisia
- Department of PathologyUniversity Hospital Mongi Slim La MarsaLa MarsaTunisia
| | - Saâdia Bouraoui
- Tunis Faculty of MedicineUniversity of Tunis El ManarTunisTunisia
- Department of PathologyUniversity Hospital Mongi Slim La MarsaLa MarsaTunisia
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8
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Shyu S, Singhi AD. Cystic biliary tumors of the liver: diagnostic criteria and common pitfalls. Hum Pathol 2020; 112:70-83. [PMID: 33383041 DOI: 10.1016/j.humpath.2020.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 02/08/2023]
Abstract
With major advancements and frequent use of abdominal imaging techniques, hepatic cysts are increasingly encountered in clinical practice. Although the majority of cysts are benign, a small subset represents neoplastic precursors to cholangiocarcinoma. These cystic precursors include intraductal papillary neoplasms of the bile duct (IPNB) and mucinous cystic neoplasms of the liver (MCN-L), and bear striking pathologic resemblance to corresponding cystic neoplastic precursors within the pancreas. This review examines the salient clinical, gross, microscopic and molecular features of IPNBs and MCN-Ls, and, in particular, provides histopathologic comparison to their pancreatic counterparts. Considering these neoplasms may be diagnostically challenging, we also discuss other hepatic lesions within the differential diagnosis, and the potential for molecular methods to improve their preoperative evaluation and the early detection of cholangiocarcinoma.
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Affiliation(s)
- Susan Shyu
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Aatur D Singhi
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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Ferreira R, Abreu P, Jeismann VB, Segatelli V, Coelho FF, David AI. Mucinous cystic neoplasm of the liver with biliary communication: case report and surgical therapeutic option. BMC Surg 2020; 20:328. [PMID: 33308210 PMCID: PMC7733287 DOI: 10.1186/s12893-020-01003-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background Mucinous cyst neoplasm of the liver (MCN-L) comprise less than 5% of all cystic liver lesions and is characterized by the presence of ovarian stroma and absence of bile duct communication. Case presentation Here, we discuss a 45-year-old woman who presented with symptomatic liver mass. Diagnostic workup detected a 4.2 × 3.6 cm septate cyst located in segments I, V, and VIII of the liver in communication with the right hepatic duct. An open right liver resection with total bile duct excision and hilar lymphadenectomy was performed. Pathology revealed a multiloculated cyst with lined mucinous epithelium and ovarian-like stroma, consistent with low-grade MCN-L. Conclusions This case shows that unusual location and bile duct communication can be present in MCN-L.
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Affiliation(s)
- Raphaella Ferreira
- Division of Liver Surgery, Santa Casa of Sao Paulo School of Medical Sciences, São Paulo, Brazil
| | - Phillipe Abreu
- Division of Liver Surgery, Santa Casa of Sao Paulo School of Medical Sciences, São Paulo, Brazil. .,Department of Surgery, Jackson Memorial Hospital, Miami Transplant Institute, University of Mami, 1801 NW 9th Ave, 7th Floor, Miami, FL, 33137, USA.
| | - Vagner Birk Jeismann
- Division of Digestive Surgery, Department of Gastroenterology, University of Sao Paulo School of Medicine, São Paulo, Brazil
| | - Vanderlei Segatelli
- Division of Clinical Pathology, Albert Einstein Israelite Hospital, São Paulo, Brazil
| | - Fabricio Ferreira Coelho
- Division of Digestive Surgery, Department of Gastroenterology, University of Sao Paulo School of Medicine, São Paulo, Brazil
| | - Andre Ibrahim David
- Division of Liver Transplant Surgery, Samaritano Higienopolis Hospital, São Paulo, Brazil
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Valdivielso Cortázar E, González Peñas L, Alonso Aguirre P. Dilation of the biliary tract secondary to intrahepathic biliary mucinous cystadenoma with ovarian stroma. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 113:470. [PMID: 33228368 DOI: 10.17235/reed.2020.7325/2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We present the case of a 55-year-old female with no history of interest and asymptomatic, who was admitted to perform studies due to findings of an abdominal ultrasound. A dilated left intrahepatic bile duct and a segment of the common hepatic duct, the proximal bile duct, was identified with irregular thickening of the wall, with an increased caliber (12 mm). A cystic lesion of 6 x 5.5 x 8 cm was also identified in the left liver lobe, with multiple septa. Computed tomography (CT) and magnetic resonance imaging (MRI) showed overlapping findings. Endoscopic retrograde cholangiopancreatography (ERCP) identified a filling defect in the common hepatic duct-left intrahepatic duct, which was not pulled with a Fogarty balloon, although it passed through it.
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Aljubran SA, Basager SA, Hakami AM, Bamashmoos MA, Alshammari MH. Extrahepatic Mucinous Biliary Cystadenoma: A Case Report. Cureus 2020; 12:e10581. [PMID: 33110717 PMCID: PMC7580493 DOI: 10.7759/cureus.10581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Biliary cysts refer to cystic dilatation in the biliary ductal system that may be congenital or acquired. Extrahepatic biliary cysts constitute less than 10% of biliary cysts. Extrahepatic mucinous cystadenoma represents an extremely rare clinical condition with less than 100 cases reported in the English medical literature. Herein, we report the case of a middle-aged woman who presented with a clinical picture of cholestatic jaundice. Laboratory findings revealed elevated bilirubin and alkaline phosphatase. After a thorough investigation, she was found to have a cystic lesion in the common bile duct near the cystic duction site. The patient underwent exploratory laparotomy, which revealed a 2.0 × 2.0 cm cystic lesion in the common bile duct that is exerting an obstructive effect on the biliary ducts. Complete en-block excision of the cystic lesion was performed with Roux-en-Y hepaticojejunostomy reconstruction. Histopathological examination revealed mucinous biliary cystadenoma. Although very rare, biliary cystadenoma should be kept in mind as a differential diagnosis of cholestatic jaundice particularly in patients with no history of biliary stones or cholecystectomy.
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