case_images: PMC10248070_01
case_images: Radiological studies. (A) Ultrasound showing the left hepatic lobe heterogeneous area. (B) CT scan with contrast showing a lesion in the left lobe of the liver demonstrates areas of internal enhancement and a mildly distended gall bladder. (C) MRCP showing a lesion in the left hepatic lobe measuring up to 5 cm. (D) MRCP showing mild gall bladder wall edema without additional signs of cholecystitis and mild CBD dilatation of 9 mm without evidence of choledocholithiasis. CT, computed tomography; MRCP, magnetic resonance cholangiopancreatography; CBD, common bile duct.
case_images: fsurg-10-1133375-g001.jpg
case_images: PMC10248070_01_fsurg-10-1133375-g001.jpg
case_images: F1
case_images: Upper abdominal ultrasonography (U/S) (Figure 1A) revealed a 6 cm heterogeneous mass in the left hepatic lobe and dilated gall bladder with mild sludge or stones. In addition, a computed tomography (CT) scan of the upper abdomen and pelvis (Figure 1B) was performed, which confirmed the U/S findings of the lesion in the left lobe of the liver and demonstrated areas of internal enhancement, and magnetic resonance cholangiopancreatography (MRCP) (Figures 1C,D) revealed mild gall bladder wall edema and a 9 mm common bile duct (CBD) dilatation of without evidence of choledocholithiasis, and it was consistent with an undetermined 5 cm mass in the left lobe of the liver.
case_images: Gross pathology and histology. (A) Gross pathology with inked margins. IPMN is shown with a yellow arrow. (B) Low-power photomicrograph demonstrating papillary fronds emanating from the cyst lining (black arrows) (hematoxylin and eosin stain; 12.5x original magnification). (C) High-power photomicrograph demonstrating a very low-grade papillary mucinous epithelium (black arrow) histologically identical to that typically seen with pancreatic intraductal papillary mucinous neoplasm. There is no evidence of underlying ovarian-type stroma (hematoxylin and eosin stain; 200x original magnification). IPMN, intraductal papillary mucinous neoplasm.
case_images: fsurg-10-1133375-g002.jpg
case_images: PMC10248070_01_fsurg-10-1133375-g002.jpg
case_images: F2
case_images: Gross pathology (Figure 2A) and histology (Figures 2B,C) revealed negative margins, and the 4.5 cm  x  3.5 cm  x  3.0 cm cystic structure from hepatic tissue represents the intrahepatic biliary IPMN (yellow arrow) (Figure 3) with low-grade dysplasia.
case_images: Gross pathology image.
case_images: fsurg-10-1133375-g003.jpg
case_images: PMC10248070_01_fsurg-10-1133375-g003.jpg
case_images: F3
case_images: Gross pathology (Figure 2A) and histology (Figures 2B,C) revealed negative margins, and the 4.5 cm  x  3.5 cm  x  3.0 cm cystic structure from hepatic tissue represents the intrahepatic biliary IPMN (yellow arrow) (Figure 3) with low-grade dysplasia. There is no gross evidence of invasion (Figure 3).