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Infrequent intrahepatic cystic neoplasm: dilemmas in diagnosis and management
  1. Dattaraj Pradeep Budkule,
  2. Gunjan Shailesh Desai,
  3. Prasad Pande and
  4. Dattaprasanna R Kulkarni
  1. Surgical Gastroenterology, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
  1. Correspondence to Dr Gunjan Shailesh Desai, desaigunjan526{at}


Biliary mucinous cystic neoplasm (BMCN) is a rare intrahepatic neoplasm comprising approximately 5% of cystic liver lesions. It can cause diagnostic dilemmas with most common differentials being complex hepatic cyst, hydatid cyst and intraductal papillary neoplasm of the bile duct. Affecting middle-aged female population, BMCN presents variedly ranging from vague abdominal symptoms to obstructive jaundice. Preoperative diagnosis is difficult. Preoperative CT scan with intravenous contrast and carbohydrate antigen 19.9 levels may give a clue towards the diagnosis. Intraoperative frozen section or cyst fluid aspiration cytology might help confirm the diagnosis. Fine needle aspirations should not be performed if BMCN is suspected, and intraoperative cyst spillage should be avoided to prevent tumour dissemination. We present here a case with a very atypical presentation of BMCN and review its present literature in brief.

  • hepatic cancer
  • surgical oncology

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  • Contributors DPB, GSD and PP contributed to acquisition of data, analysis and interpretation of data, drafting the article, agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved. DRK contributed to conception and design, final approval of the version published and critical appraisal of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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