# Intrahepatic biliary cystadenoma, a challenging diagnosis and management: A case report

## TL;DR

This case report describes a rare liver tumor called biliary cystadenoma, emphasizing the challenges in diagnosis and the importance of surgery and imaging.

## Contribution

The paper contributes a detailed case report highlighting the diagnostic and management challenges of intrahepatic biliary cystadenoma.

## Key findings

- Biliary cystadenoma is a rare benign tumor with potential for malignancy, requiring surgical resection.
- Imaging techniques like MRI aid diagnosis, but preoperative accuracy is less than 50%.
- Multidisciplinary collaboration is essential for optimal diagnosis and treatment planning.

## Abstract

Biliary cystadenoma (BC) is a benign hepatic cystic tumor with degenerative potential. Hepatic MRI can help guide the diagnosis. Surgical resection is recommended due to the malignant potential of biliary cystadenomas. Only anatomopathological examination of the surgical specimen can establish the definitive diagnosis of BC. The objective of this case report is to enhance our understanding of this disease and contribute to precise diagnosis for optimal management.

A 55-year-old woman with a history of hypertension and atrial fibrillation presented to the surgery department with paroxysmal right hypochondrial pain. Ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) revealed a large septated cystic lesion occupying segments II, III, and IV of the liver. The patient underwent left hepatectomy without incident. The postoperative course was marked by a deep collection opposite the sectional area, which was successfully treated with antibiotics and radiological drainage. The pathological diagnosis confirmed BC without signs of malignancy, and no recurrence was detected post-surgery.

The rarity of BC, the absence of specific clinical signs and its potential for malignant transformation, underline the need for sophisticated imaging techniques. However, preoperative radiological diagnosis does not exceed 50 %. The operative decision requires a multidisciplinary discussion between radiologists and surgeons. This case highlights the unavailability of radical surgical treatment in cases of strong preoperative suspicion of BC. The cooperation of the pathologist in the histological diagnosis is crucial.

The diagnosis of BC should be considered in cases of multilocular cystic lesions in the liver, particularly in instances of recurrent cysts. Imaging aids in both positive and differential diagnoses. Complete resection is the recommended treatment for any suspected BC.

•Rare benign tumor with malignant potential•Case presentation and diagnostic techniques•Multidisciplinary approach and postoperative management•Importance of imaging in diagnosis and treatment planning

Rare benign tumor with malignant potential

Case presentation and diagnostic techniques

Multidisciplinary approach and postoperative management

Importance of imaging in diagnosis and treatment planning