Resected Case of Intrahepatic Bile Duct Cystadenoma with Mesenchymal Stroma Accompanied with Right-Sided Round Ligament

Makoto Yoshida, Motoya Kashiyama, Setsuji Takanashi, Takumi Takagi, Shigenori Masaki and Hideaki Kawashima

Department of Surgery, Kin-ikyou Chuo Hospital

Intrahepatic bile duct cystadenoma is a rare cystic tumor of the liver. That with histopathologically ovarian-like stroma termed cystadenoma with mesenchymal stroma. All patients are female. The right-sided round ligament is a rare anomaly mostly accompanied by abnormal intrahepatic portal venous branching-something to be noted in hepatectomy. A 72-year old woman admitted for detailed checking of a liver tumor was found in abdominal CT to have a multilocular 6.0×5.5 cm cystic tumor at segments 5 and 8 of the liver. Part of the tumor wall had calcified, and no intracystic nodules were seen. Serum CA19-9 was elevated. Under the diagnosis of hepatobiliary cystic tumor, we performed conducted right hepatic lobectomy. The round ligament ran near the tumor into the liver, with the gallbladder to its left. Intraoperative ultrasound sonography showed the left umbilical portion to be nonexistent and the round ligament running to the right anterior banch of the portal vein. We diagnosed intrahepatic bile duct cystadenoma with mesenchymal stroma histopatholigically. Postoperative serum CA19-9 became normal and the man remains well without recurrence.

Key words
intrahepatic bile duct cystadenoma, mesenchymal stroma, right-sided round ligament

Reprint requests
Makoto Yoshida Department of Surgery, Kin-ikyou Chuo Hospital
2-15-1 10-jo Fushiko, Sapporo, 007-8505 JAPAN

Accepted
September 26, 2007

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