KOSIN UNIVERSITY COLLEGE OF MEDICINE
Articles
- Page Path
- HOME > Kosin Med J > Volume 31(2); 2016 > Article
-
Case Report
Biliary Cystadenoma Causing Esophageal Varices - Sung Ju Kang, Tae Hee Lee, Min Gyu Seok, Hyo Jin Yun, Ye Seul Jang, Jun Hyun Byun
-
Kosin Medical Journal 2016;31(2):191-196.
DOI: https://doi.org/10.7180/kmj.2016.31.2.191
Published online: January 20, 2016
Department of Internal Medicine, College of Medicine, Konyang University, Daejeon, Korea
- Corresponding Author: Tae Hee Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University College of Medicine, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: +82-42-600-9370 Fax: +82-42-600-9090 E-mail: green740@naver.com
• Received: August 18, 2015 • Accepted: September 21, 2015
Copyright © 2016 Kosin University School of Medicine Proceedings
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
- 770 Views
- 5 Download
Abstract
- Biliary cystadenomas are benign but potentially malignant cystic neoplasm. The preferred treatment is radical resection because it is difficult to differentiate a benign from a malignant biliary cystadenoma. A 40 year-old woman presented with moderate abdominal discomfort. Esophageal varix was found up to mid-esophagus on endoscopy. She has no prior history of liver disease or chronic alcohol ingestion. About 15cm sized biliary cystadenoma was diagnosed by ultrasonography, computed tomography and magnetic resonance imaging. Serum level of bilirubin, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase and tumor marker were elevated. The patient underwent US-guided aspiration. Tumor markers from the aspirated fluid are increased. Left hepatectomy was performed to completely remove the cyst. Histology of the resected specimen confirmed a biliary cystadenoma of the liver with ovary-like stroma. Without prior history of liver disease or chronic alcoholic ingestion, incidental finding of esophageal varix could show an important clue for diagnosis of biliary cystadenoma.
Fig. 4.Cyst histology typical of a mucinous cystadenoma(A) Biliary cyst shows ovary like stroma (H &E stain, x400). (B) Arrow demonstrating ovary like stroma.
Fig. 5.Endoscopy image before operation demonstrating esophageal varix upto midesophagus.(A) Follow up endoscopy after lobectomy shows disappearance of esophageal varix.
- 1. Del Poggio P, Buonocore M. Cystic tumors of the liver: a practical approach. World J Gastroenterol 2008;14:3616–20.ArticlePubMedPMC
- 2. Ratti F, Ferla F, Paganelli M, Cipriani F, Aldrighetti L, Ferla G. Biliary cystadenoma: short- and longterm outcome after radical hepatic resection. Updates Surg 2012;64:13–8.ArticlePubMed
- 3. Grubor NM, Colovic RB, Atkinson HD, Micev MT. Giant biliary mucinous cystadenoma of the liver. Ann Hepatol 2013;12:979–83.ArticlePubMed
- 4. Erdogan D, Kloek J, Lamers WH, Offerhaus GJ, Busch OR, Gouma DJ, et al. Mucinous cystadenomas in liver: management and origin. Dig Surg 2010;27:19–23.ArticlePubMed
- 5. Gamblin TC, Holloway SE, Heckman JT, Geller DA. Laparoscopic resection of benign hepatic cysts: a new standard. J Am Coll Surg 2008;207:731–6.ArticlePubMed
- 6. Choi HK, Lee JK, Lee KH, Lee KT, Rhee JC, Kim KH, et al. Differential diagnosis for intrahepatic biliary cystadenoma and hepatic simple cyst: significance of cystic fluid analysis and radiologic findings. J Clin Gastroenterol 2010;44:289–93.PubMed
- 7. Ryu KH, Lee TH, Kwon TG. Vascular lesion in an adult mimicking esophageal varix. Gastroenterololy 2013;144:35.Article
References
Figure & Data
References
Citations
Citations to this article as recorded by 
PubReader
ePub Link
Cite
XML Download
