Kunovsky L, Kala Z, Svaton R, Moravcik P, Mazanec J, Husty J, Prochazka V

Language: English
References: 11
Page: 519-524
PDF size: 262.41 Kb.

ABSTRACT

Mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) are diagnoses that were classified by the World Health Organization in 2010 as mucin-producing bile duct tumors of the hepatobiliary system. The preoperative differential diagnosis between these two entities is difficult; the presence of a communication with the bile duct is usually considered as a typical sign of IPMN-B. However, the presence of an ovarian-like stroma (OLS) has been established to define the diagnosis of MCN-L. We present the case of a 33-year-old woman with a rapid progression of a cystic tumor of the liver. In 2 years, the lesion increased from 27 to 64 mm and a dilation of the left hepatic duct appeared. Percutaneous transhepatic drainage with a biopsy was performed. No malignant cells were found on biopsy. Because of the rapid progression of the cystic tumor and unclear malignant potential, left hemihepatectomy was performed. Even though tumor masses were present in the biliary duct, on the basis of the presence of OLS, histology finally confirmed MCN-L with intermediate-grade intraepithelial dysplasia to high-grade intraepithelial dysplasia. The patient is currently under oncologic follow-up with no signs of recurrence of the disease. We present a rare case where MCN-L caused a dilation of the left hepatic duct, a sign that is usually a characteristic of IPMN-B.

REFERENCES

1. Kubota K, Hachiya H, Nakanuma Y, Kondo F, Miyazaki M, Nagino M, Yamamoto M, et al. Clinicopathological features and prognosis of mucin-producing bile duct tumor and mucinous cystic tumor of the liver: A multi-institutional study by the Japan Biliary Association. J Hepato-Biliary-Pancreat Sci 2014; 21: 176-85.

2. Obara S, Nomi T, Yamato I, Hokuto D, Yasuda S, Nishiwada S, Kawaguchi Ch, et al. Laparoscopic resection of a hepatic mucinous cystic neoplasm: A case report. Int J Surg Case Rep 2016; 24: 18-21.

3. Nakayama Y, Kato Y, Okubo S, Takahashi D, Okada R, Nishida Y, Kitaguchi K, et al. A case of mucinous cystic neoplasm of the liver: a case report. Surg Case Rep 2015; 1: 9-9.

4. Li T, Zhi X, Ji Y, Wang L, Yang X, Shi G, Zhang W, et al. A Comparison of Hepatic Mucinous Cystic Neoplasms With Biliary Intraductal Papillary Neoplasms. Clin Gastroenterol Hepatol 2009; 7: 586-93.

5. Budzynska A, Hartleb M, Nowakowska-Dulawa E, Krol R, Remiszewski P, Mazurkiewicz M. Simultaneous liver mucinous cystic and intraductal papillary mucinous neoplasms of the bile duct: A case report. World J Gastroenterol 2014; 20: 4102-5.

6. Ghatak S, Ray S, Sonar PK, Das S, Basu K, Mridha AR, Bhattacharyya A, et al. Giant mucinous cystic neoplasms of pancreas and liver with unusual adipose tissue component: a case report. J Gastrointest Oncol 2012; 3: 352.

7. Zen Y, Pedica F, Patcha V, Capelli P, Zamboni G, Casaril A, Quaglia A, et al. Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct. Mod Pathol 2011; 24: 1079-89.

8. Simo K, Mckillop I, Ahrens W, Martinie J, Iannitti D, Sindram D. Invasive biliary mucinous cystic neoplasm: a review. HPB 2012; 14: 725-40.

9. Wang X, Cai Y-Q, Chen Y-H, Liu X-B. Biliary tract intraductal papillary mucinous neoplasm: Report of 19 cases. World J Gastroenterol 2015; 21: 4261-7.

10. Takano Y, Nagahama M, Yamamura E, Maruoka N, Mizukami H, Tanaka J, Ohike N, et al. Prolapse into the bile duct and expansive growth is characteristic behavior of mucinous cystic neoplasm of the liver: report of two cases and review of the literature. Clin J Gastroenterol 2015; 8: 148-55.

11. Zen Y, Jang K-T, Ahn S, Kim DH, Choi DW, Choi SH, Heo JS, et al. Intraductal papillary neoplasms and mucinous cystic neoplasms of the hepatobiliary system: demographic differences between Asian and Western populations, and comparison with pancreatic counterparts. Histopathology 2014; 65: 164-73.