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Prolapse into the bile duct and expansive growth is characteristic behavior of mucinous cystic neoplasm of the liver: report of two cases and review of the literature.

Takano Y, Nagahama M, Yamamura E, Maruoka N, Mizukami H, Tanaka J, Ohike N, Takahashi H - Clin J Gastroenterol (2015)

Bottom Line: Both cases exhibited MCN-L that originated from the left hepatic lobe (Segment 4) and then prolapsed into the left hepatic duct and common bile duct, resulting in obstructive jaundice due to expansive growth.Prolapse into the bile duct and expansive growth appear to be characteristic behavior of MCN-L.In the future, additional data on more cases needs to be collected to further elucidate MCN-L pathophysiology.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama-shi, Yokohama, Kanagawa, 227-8501, Japan, yuichitakano1028@yahoo.co.jp.

ABSTRACT
Mucinous cystic neoplasm of the liver (MCN-L) is a very rare tumor whose detailed behavior is still unknown. We describe two cases of MCN-L that exhibited extremely interesting growth patterns, and discuss the characteristics of MCN-Ls. Both cases exhibited MCN-L that originated from the left hepatic lobe (Segment 4) and then prolapsed into the left hepatic duct and common bile duct, resulting in obstructive jaundice due to expansive growth. Endoscopic retrograde cholangiopancreatographies showed the characteristic oval-shaped filling defects in the bile ducts. Endoscopic ultrasound and intraductal ultrasound were useful for differentiating the tumors from stones, since multiple septal formations were observed inside the tumors. A literature search revealed that, over the past 10 years, 15 cases of MCN-L (biliary cystadenomas with ovarian-like stroma) that showed expansive growth in the bile duct had been reported. Prolapse into the bile duct and expansive growth appear to be characteristic behavior of MCN-L. In the future, additional data on more cases needs to be collected to further elucidate MCN-L pathophysiology.

No MeSH data available.


Related in: MedlinePlus

a An incision was made in the common bile duct, which was filled with the tumor (arrow). b A multi-locular cystic tumor was noted in the S4 liver segment, and had prolapsed into the left hepatic duct and common bile duct
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Fig2: a An incision was made in the common bile duct, which was filled with the tumor (arrow). b A multi-locular cystic tumor was noted in the S4 liver segment, and had prolapsed into the left hepatic duct and common bile duct

Mentions: Macroscopic findings indicated a multi-locular cystic tumor in S4 of the liver. It had prolapsed into the left hepatic duct and common bile duct (Fig. 2a, b). Microscopic findings revealed that the cystic lesion was lined with mucinous cuboidal epithelium, and OLS was observed extensively in the cyst wall stroma (Fig. 3). The OLS was positive for both progesterone and estrogen receptors. A definitive diagnosis of MCN-L with low-grade dysplasia was therefore made.Fig. 2


Prolapse into the bile duct and expansive growth is characteristic behavior of mucinous cystic neoplasm of the liver: report of two cases and review of the literature.

Takano Y, Nagahama M, Yamamura E, Maruoka N, Mizukami H, Tanaka J, Ohike N, Takahashi H - Clin J Gastroenterol (2015)

a An incision was made in the common bile duct, which was filled with the tumor (arrow). b A multi-locular cystic tumor was noted in the S4 liver segment, and had prolapsed into the left hepatic duct and common bile duct
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4481294&req=5

Fig2: a An incision was made in the common bile duct, which was filled with the tumor (arrow). b A multi-locular cystic tumor was noted in the S4 liver segment, and had prolapsed into the left hepatic duct and common bile duct
Mentions: Macroscopic findings indicated a multi-locular cystic tumor in S4 of the liver. It had prolapsed into the left hepatic duct and common bile duct (Fig. 2a, b). Microscopic findings revealed that the cystic lesion was lined with mucinous cuboidal epithelium, and OLS was observed extensively in the cyst wall stroma (Fig. 3). The OLS was positive for both progesterone and estrogen receptors. A definitive diagnosis of MCN-L with low-grade dysplasia was therefore made.Fig. 2

Bottom Line: Both cases exhibited MCN-L that originated from the left hepatic lobe (Segment 4) and then prolapsed into the left hepatic duct and common bile duct, resulting in obstructive jaundice due to expansive growth.Prolapse into the bile duct and expansive growth appear to be characteristic behavior of MCN-L.In the future, additional data on more cases needs to be collected to further elucidate MCN-L pathophysiology.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama-shi, Yokohama, Kanagawa, 227-8501, Japan, yuichitakano1028@yahoo.co.jp.

ABSTRACT
Mucinous cystic neoplasm of the liver (MCN-L) is a very rare tumor whose detailed behavior is still unknown. We describe two cases of MCN-L that exhibited extremely interesting growth patterns, and discuss the characteristics of MCN-Ls. Both cases exhibited MCN-L that originated from the left hepatic lobe (Segment 4) and then prolapsed into the left hepatic duct and common bile duct, resulting in obstructive jaundice due to expansive growth. Endoscopic retrograde cholangiopancreatographies showed the characteristic oval-shaped filling defects in the bile ducts. Endoscopic ultrasound and intraductal ultrasound were useful for differentiating the tumors from stones, since multiple septal formations were observed inside the tumors. A literature search revealed that, over the past 10 years, 15 cases of MCN-L (biliary cystadenomas with ovarian-like stroma) that showed expansive growth in the bile duct had been reported. Prolapse into the bile duct and expansive growth appear to be characteristic behavior of MCN-L. In the future, additional data on more cases needs to be collected to further elucidate MCN-L pathophysiology.

No MeSH data available.


Related in: MedlinePlus