Patient Demographics |
60-year-old Caucasian male |
28-year-old Caucasian female |
Clinical Presentation |
Incidental discovery of an 8 × 8 × 9 cm hepatic cyst |
Presented with dyspnea, vomiting, jaundice, fever |
Initial Diagnosis |
Suspected hydatid cyst |
Simple cyst, later adenocarcinoma with metastases |
Diagnostic Methods |
MRI, MRCP, ERCP, histopathological examination |
CT, MRI, laparoscopic liver biopsy, histopathological examination |
Tumor Characteristics |
Large cystic mass, thin walls, internal septa, papillary projections, enhancing solid components |
Large lesion in left hepatic lobe, hyperintensity in T2-weighted images, restricted diffusion, contrast enhancement |
Treatment |
Cyst resection, cholecystectomy |
Thrombectomy, chemotherapy, supportive care |
Surgical Findings |
Partially exophytic floating soft mass |
Extensive intrahepatic metastases, vascular involvement |
Histopathological Findings |
IPNB with foci of adenocarcinoma, oncocytic appearance, varying degrees of dysplasia, mucus within cyst |
Adenocarcinoma with papillary clear cell and mucinous appearance, gland ectasis, cystic or pseudocystic aspects |
Follow-up and Outcome |
Initial recurrence-free survival for 8 years, recurrence treated with left hepatectomy, patient alive at 33 months post-second surgery |
Disease progression despite aggressive management, patient died from hepatic failure |