A Case of Intrahepatic Bile Duct Cystdenoma with Marked Old Hemorrhage

Michiya Kobayashi, Keijiro Araki, Yoshihito Kohama, Hiroyuki Kwaasaki, Shuji Kawai, Takuro Ogata

First Department of Surgery, Kochi Medical School

We experienced a case of intrahepatic bile duct cystadenoma with marked hemorrhage. A 51-year-old man was admitted to our hospital with a liver tumor. Physical examination revealed the no abnormal findings. Laboratory data on admission showed the no elevation of the tumor markers (carcinoembryonic antigen, alphafetoprotein, carbohydrate antigen 19-9 and protein induced by vitamin K antagonists-2). Abdominal ultrasonography revealed an isoechoic round tumor in the left lateral segment of the liver. Abdominal CT revealed an isodensity mass without enhancement in the same region. These findings suggested a cystic mass, however, there was thickening of the cyst wall and the mass had echogenicity in ultrasonography. He underwent partial resection of the left lateral segment. Macroscopic findings showed that the cystic tumor measured 7.0×6.5×7.0 cm and contained paletan dirty fluid (140 ml) with a necrotic mass. Histological findings revealed a cystic lesion with marked hemorrhage. The most of the lining cells of the cyst wall were desquamated, however some part of the wall was lined with cuboidal or columnar epithelium with lower papillary projection, and was diagnosed as intrahepatic bile duct cystadenoma.

Key words
cystic lesion of the liver, intrahepatic bile duct cystadenoma, diagnostic imaging

Reprint requests
Michiya Kobayashi First Department of Surgery, Kochi Medical School
Kohasu Oko-cho, Nankoku, 783 JAPAN

Accepted
June 8, 1994

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