case_images: PMC10847894_01
case_images: Abdominal CT scan. Axial arterial phase (A) axial venous phase, (B) coronal venous, (C) and sagittal venous, and (D) CT images of the abdomen show a large circumscribed hypoattenuating cystic structure (white arrows) within the caudate lobe of the liver measuring up to 10.7 cm, causing a significant mass effect on the surrounding structures, including the IVC (black arrow) and hepatic veins. There is a background of moderate hepatic steatosis. No vascular invasion or lymphadenopathy.
case_images: cureus-0016-00000051832-i01.jpg
case_images: PMC10847894_01_cureus-0016-00000051832-i01.jpg
case_images: FIG1
case_images: CT scan showed hepatomegaly, steatosis, and two low-density fluid-filled intrahepatic cystic lesions, the largest in the caudate lobe up to 10.7 cm causing mass effect compression of hepatic veins and inferior vena cava (Figure 1). Compared to her last CT scan, which was one year ago, the large cyst in the caudate lobe was 7.5 x 6.7 cm.
case_images: Microscopic picture of cyst wall. Collapsed thin cyst wall (A) lined by one layer of flat to low cuboidal cells, (B) diffusely reactive for the mesothelial marker, and (C) calretinin X5
case_images: cureus-0016-00000051832-i02.jpg
case_images: PMC10847894_01_cureus-0016-00000051832-i02.jpg
case_images: FIG2
case_images: Microscopic examination showed a thin fibro-connective cyst wall lined by a single layer of flat to low cuboidal cells consistent with benign mesothelium and supported by characteristic calretinin-positive immunohistochemical reactivity (Figure 2).