CASE REPORT

Extrahepatic Biliary Cystadenoma with Mesenchymal Stroma: a True Biliary Cystadenoma? A Case Report

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Derek B Hennessey, Oscar Traynor

Department of Hepatobiliary and Liver Transplant Surgery, St. Vincent's University Hospital, Elm Park,
Dublin 4, Ireland


Abstract


Biliary cystadenomas are benign but potentially malignant cystic neoplasms, which classically contain mesenchymal stroma similar to ovarian tissue. We report a case of an extra-hepatic biliary cystadenoma with mesenchymal stroma along with a discussion of current pathological opinion.

Case presentation
: A 54-year-old female presented with abdominal pain, abnormal liver function tests and a mass on ultrasound. Computerized Tomography identified a complex multi-locular cyst in the common hepatic duct. Radical excision of the lesion and a Roux-en-Y loop bilio-enteric anastomosis was performed. Histology confirmed the presence of a benign biliary cystadenoma with ovarian type stroma.

Conclusion
: Biliary cystadenomas classically contain mesenchymal stroma similar to ovarian tissue. It now appears that cystadenomas without mesenchymal stroma appear to be more akin to similar cystic lesions of the pancreas, and may represent a dissimilar neoplasm. Therefore, malignant transformation can occur, so complete excision is recommended.

Key words

Cystadenoma - biliary cystic tumour - cystoadenocarcinoma - mesenchymal stroma - intra-ductal papillary neoplasm - hepatic neoplasm