Intrahepatic biliary cystadenoma with mesenchymal (ovarian) stroma in an elderly female: A rare entity

Rationale: Intrahepatic Biliary cystadenoma is a family of rare cystic neoplasms of liver that accounts for less than 5% of nonparasitic hepatic cystic lesions. It usually occurs in middle-aged females. It is a slowly growing benign tumor with nonspecific clinical manifestations that has malignant potential, especially those with mesenchymal ovarian stroma. Patient Concerns: 42-year-old female who presented in OPD with right upper abdominal pain associated with vomiting that was clinico-radiologically diagnosed as Hydatid cyst of the liver. Diagnosis: Exploratory laparotomy was done for the cystic lesion present in the left lobe of liver and the excised cystic tissue piece was sent for histopathological examination. A final diagnosis of Intrahepatic biliary cystadenoma with mesenchymal stroma was made after thorough histopathological examination. Interventions: Deroofing of the cyst with partial capitonnaging with omentopexy was done. Outcome: Our patient was followed up after management and since then no abnormality or sign of recurrence was seen. This also relates to its good prognostic value. Lessons: Intrahepatic Biliary cystadenoma with mesenchymal stroma, when compared to other benign cystic lesion of the liver, have more chances of recurrence as well as malignant transformation if not completely excised. Therefore, through this case report we wish to raise awareness amongst clinicians regarding this rare cystic lesion of liver especially when surgical management of hepatic cystic lesions is considered.