Differential Diagnosis Difficulty between Biliary Cystadenoma and Cystaadenocarcinoma of the Liver: A Case Report

Biliary cystadenoma is a multilocular cystic benign tumor which arises in the intrahepatic biliary system. Diagnosis is often difficult and based on imaging, however histology remains the only argument for diagnosis certainty. We report a case of biliary cystadenoma in a 69-year-old female. Observation: it was a 69-year-old female with history of RHUPUS syndrome (Lupus + Rheumatoid arthritis) under low-dose corticosteroid therapy. She presented with pain in the right hypochondrium with permanent moderate intensity for 3 months associated to altered performance status. Physical examination showed a hepatomegaly, cervical subluxation, and pulmonary condensation syndrome. Hepatobiliary ultrasound showed presence of multiple septate cystic formations occupying segments 1, 7, 8, 5 of the left liver. Abdominal CT scan and hepatic MRI were in favor of biliary cystadenoma but could not rule out biliary cystadenocarcinoma with certainty. Conclusion: biliary cystadenoma is a benign cystic tumor of the liver. The differential diagnosis with cystadenocarcinoma is most often difficult and usually requires histological analysis for diagnostic certainty.