Episodic Biliary Obstruction: Intrahepatic Biliary Cystadenoma

Abstract

Ashwin Rammohan, Jeswanth Sathyanesan, Ravichandran Palaniappan

Biliary cystadenomas are rare, benign but potentially malignant, multilocular, cystic neoplasms of a biliary origin. They often present with non-specific symptoms. We present a rare case of an intrahepatic biliary cystadenoma causing luminal obstruction to the bile duct. A 32-year-old female with obstructive jaundice was evaluated and diagnosed as having a cystic lesion in the liver. With a preoperative differential diagnosis of a hydatid cyst, she underwent laparotomy and enucleation of the lesion. Intraoperatively, the tumor was found to be extending into the bile duct, which was occluding the lumen. This was excised and a bilioenteric anastomosis was done. Her postoperative period was uneventful and she was anicteric on follow-up. Biliary cystadenoma should be considered a differential diagnosis when radiologic imaging studies suggest a multilocular cystic hepatic lesion. Presence of jaundice in such patients should raise the suspicion of an intrabiliary component, the omission of which can lead to avoidable postoperative morbidity