A 67-year-old male with a history of left hemifacial spasm, complaining of episodes of abdominal pain in the epigastrium and right hypochondrium, fever and choluria for four years.
Physical examination revealed right hypochondrium pain with negative Murphys test results, with a slight increase in transaminase levels.
Ultrasound shows a cystic image of 4 cm at the level of the hepatic hilium.
Abdominal CT showed dilation of the bile duct with hypodense lesion in the hepatic hilium.
A cystic lesion of 6 cm in diameter, polylobulated with compression of the intrahepatic bile duct without enhancement after contrast uptake is observed at the level of the hepatic hilium.
Given the episodes of cholangitis diagnosed as biliary disease and explored via laparotomy was decided, observing an intrahepatic cystic tumor in segments IV-III that, after a cholangioma.
Cholecystectomy and left hepatectomy were performed, with favorable postoperative evolution.
Histology describes a lesion consisting of multiple cysts of the fibrous wall, fixed by mucus-secretory epithelium with flat areas, papillary proyelocalies reach, cytological atypia and a solid nodule of the focal hepatic cyst.
There was no evidence of ovarian stroma.
All this is compatible with the diagnosis of hepatic cystadenocarcinoma.
Five years later, the patient is asymptomatic without recurrence signs.
