A Case of Solitary Hepatic Cyst with Accessory Sulci of Liver (original) (raw)
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Case Report of Large Simple Hepatic cyst
IOSR Journals , 2019
Most liver cysts are benign, even though early diagnosis plays vital role for proper treatment of parasitic or cancerous subtypes. Simple hepatic cysts may be isolated or multiple and may vary from a few millimeters to several centimeters in diameter. Giant cysts of the liver are uncommon. A 60 years female patient was malnourished and pale. Vitals were stable. On per abdomen examination, a mass felt in right hypochondria region extended up to right lumbar region associated with tenderness, firm in consistency. On percussion it was dull. CT scan revealed a large hypodense lesion in segment VI & VII completely replacing and compressing the right lobe of liver, measuring approximately 21 X 13 cm. No evidence of obvious calcifications. During surgery, large hepatic cyst was noted involving right lobe and left lobe of liver and right dome of diaphragm. Falciparum ligament appears thinner than usual. From this hepatic cyst 2.5 liters of fluid was drained out. Histopathological findings noted were cyst wall showing fibrous tissue, lymphocytes, small ducts lined by cuboidal epithelium and few hepatocytes attached to cyst wall suggestive of simple hepatic cyst. Accurate diagnosis will help for prompt management. Even though most of the hepatic cysts are benign, better to undergo investigations such as CT, Histopathology examination to rule out differential diagnosis and to alleviate any further complications.
Unusual cystic liver lesions: a pictorial essay
European Journal of Radiology, 1993
Cystic liver lesions are being increasingly detected by ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). These lesions produce a wide spectrum of radiological features. Unfortunately their appearance is not always specific and they may resemble ad be mistaken for other lesions. Cystic lesions can be classified into congenital, inflammatory, neoplastic and miscellaneous groups. In this pictorial essay a number of unusual cystic lesions are illustrated with a brief analysis of morphological features of the individual lesion and a diagnostic approach for cystic liver lesions is suggested.
A symptomatic cyst of the ligamentum teres of the liver: A case report
World Journal of Gastroenterology, 2008
Cysts of the liver ligaments are extremely rare and cysts of the ligamentum teres of the liver have been sporadically reported in the literature during the last century. The present report describes a case of a symptomatic patient with a cyst of the ligamentum teres of the liver. The patient presented with right upper quadrant pain and indigestion during the last 2 years. Ultrasound and computed tomography scans revealed a water-density mass attached to the anterior abdominal wall, but definite diagnosis could not be reached. The cyst was completely excised during laparotomy. Cysts of the ligamentum teres of the liver, although infrequent, may produce clinical symptoms and require excision. Ultrasound and computed tomography scan preoperatively cannot rule out malignancy, thus exploratory laparotomy and total resection of these lesions are necessary.
CYSTIC LIVER LESIONS: A COMPREHENSIVE REVIEW (Atena Editora)
CYSTIC LIVER LESIONS: A COMPREHENSIVE REVIEW (Atena Editora), 2022
Introduction: Cystic lesions of the liver (LCF) are frequent findings in clinical practice and have an asymptomatic course in most cases. However, there is diagnostic diversity. Advances in imaging methods such as ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) have allowed greater assertiveness, which allows the surgeon to establish an appropriate therapeutic approach. Objective: To review the literature and compile the concordance of characteristics in the diagnosis of LCF. Method: Bibliographic review of digital databases and physical literature from the last decades. Results: The Simple Hepatic Cyst is a formation with fluid content and can reach up to 1% of incidence in necropsies. On US, an anechoic, unilocular, fluid-filled area with no visible walls is observed. On CT, the lesion is well-defined, filled with fluid with water-like attenuation. It was verified that the Polycystic Liver Disease, an autosomal dominant disease, frequents 40% of the diagnoses of LCF. The characteristic on CT is multiple, homogeneous, hypoattenuated lesions with regular contours. Hydatid cysts have the liver as the main site, causing LCF in 52% to 77% of cases. They are caused by infection with E. granulosus. On CT, well-defined hypoattenuating lesions with wall calcification are found. Hepatobiliary cystadenoma is a rare LCF considered to be neoplastic, with an incidence of around 5%. Malignancy can be seen in 5 to 15% of cases. On CT, a uni or multilocular hypoattenuating mass with septations is found. Caroli's Disease also known as congenital ectatic cavernous communication of the biliary tract characterized by saccular dilatation of the intrahepatic ducts, multiple calculi; has an incidence of 1 in 1,000,000. On CT, dilated and hypoattenuated cystic structures are observed. Corresponding to a small part of the LCF there are also the Traumatic Cysts. As the nomenclature says, they occur after trauma that leads to the disjunction of the bile ducts or the formation of subcapsular hematoma. On CT, lacerations and/or hematomas with low parenchymal attenuation are found. Conclusion: LCFs have different characteristics from each other. The diagnosis depends on armed propaedeutics and, the more accurate it is, the more effective treatment will be possible.
American Journal of Roentgenology, 2011
Cystic liver lesions, or fluid-containing lesions of the liver, are commonly encountered findings on radiologic examinations that may represent a broad spectrum of entities ranging from benign developmental cysts to malignant neoplasms (Table 1). The wide range of pathologic processes that may result in cystic liver lesions can present a difficult diagnostic conundrum. The radiologist must carefully assess such imaging features as location, size, and unifocal or multifocal nature of the cyst or cysts as well as evaluate cyst complexity and associated findings. In addition, because radiologic features of various cystic liver lesions overlap, it is necessary to integrate imaging with clinical and laboratory findings to allow more definitive diagnosis. An important first step in narrowing the differential diagnosis is to determine the presence or absence of complex features in cystic liver lesions. To this end, fluid-containing liver lesions can be grouped broadly into simple or complex cysts.
Cystic lesions in the liver: benign or malignant?
Acta chirurgica Belgica
A 65-year old patient is presented with an ultrasound showing multiple cysts in liver and both kidneys. Computed tomography scan (CT-scan) showed a cyst in the right liver lobe with a largest diameter of 12 cm, suspicious for cystadenocarcinoma. Further staging showed no extrahepatic metastasis. Considering possible malignancy, aspiration of the cyst was not an option because of the risk for ent-metastasis. Resection of the tumour was considered as the best treatment. Peroperatively the cyst was localized with ultrasound, after which an extended right hepatectomy was performed. No peroperative complications occurred. Histological diagnosis was a cyst, originating in dilated von Meyenburg complexes. No signs of a biliary cystadenoma or malignant deformation were observed. A CT-scan 1 year postoperatively showed some other small cysts in the left liver lobe, the patient was free of any complaints. The differential diagnosis in cases of asymptomatic liver cysts will be discussed.
Simple Hepatic Cyst: A Case Report
The term hepatic cyst usually refers to solitary non-parasitic cysts of the liver also known as simple cysts.The most common benign lesion found in the liver is the congenital or simple cyst. They are believed to be congenital in origin. Asymptomatic simple cysts are best managed conservatively. The preferred treatment for symptomatic cysts is ultrasound or CT-guided percutaneous cyst aspiration followed by sclerotherapy. If percutaneous treatment is unavailable or ineffective, treatment may include either laparoscopic or open surgical cyst fenestration. Unroofing of the extrahepatic portion of the cyst may be done.We report a case of simple hepatic cyst that presented with abdominal pain and its management.
Primary Hepatic Lymphoma Presenting as an Isolated Solitary Hepatic Cyst
Journal of Clinical Oncology, 2013
A 76-year-old Hispanic woman with a past medical history of diabetes, hypertension, hyperlipidemia, and paroxysmal atrial fibrillation presented with chronic right-sided chest and abdominal pain. She had no other symptoms, including fever, weight loss, or anorexia. A physical examination revealed an irregular cardiac rhythm, no lymphadenopathy, and a soft abdomen with mild tenderness to palpation in the right subcostal area with a palpable mass. Laboratory tests revealed a normocytic anemia with hemoglobin level of 10.4 mg/dL and a normal WBC count, liver-function tests, carcinoembryonic antigen, Ca19-9, and ␣-fetoprotein. A computed tomography scan demonstrated a 12-cm exophytic low-density cystic mass with peripheral nodularity in segment six of the liver (Fig 1). Radiographic characteristics were read as consistent with a biliary cystadenoma, biliary cystic adenocarcinoma, or a cystic hepatic carcinoma. Because of her symptoms, the patient underwent operative exploration and intraoperative ultrasound of the mass (Fig 2), which revealed a large complex cystic mass with solid components and mural nodularity concerning for a hepatobiliary malignancy. There was no ascites, extrahepatic masses, or intra-abdominal/retroperitoneal lymphadenopathy. The patient underwent an uncomplicated hepatic resection of the mass including segment VI of the liver. The specimen was cross-sectioned, which confirmed a complex cystic mass within the liver parenchyma and a grossly negative surgical margin (Fig 3). The patient had an uncomplicated postoperative course and complete resolution of her abdominal pain on postoperative follow-up.