title: Hepatobiliary rhabdomyosarcoma mimicking choledochal cyst: Lessons learned.
abstract: BACKGROUND
  The differential diagnosis of hepatic cystic lesions is a challenging process especially in case of hepatic rhabdomyosarcoma (HRMS) presenting as hepatic cyst.
  
  
  METHODS
  We introduce our experience with a case of HRMS in a 3-year-old female patient who was misdiagnosed to have type IV-A choledochal cyst and definitive correct diagnosis was reached after the pathological and immunohistochemical examination of the surgically resected lesion. This case presentation is followed by important practical messages to hepatobiliary surgeons regarding HRMS.
  
  
  CONCLUSIONS
  HRMS is a rare pediatric tumor. Jaundice is the most common presentation of HRMS followed by abdominal pain and vomiting. Great effort is needed to differentiate the tumor from choledochal cyst and infectious hepatitis. Through evaluation using available imaging studies together with clinical anticipation is mandatory for establishing the correct diagnosis.
  
  
  CONCLUSIONS
  Differentiation of HRMs from choledochal cyst mandates through evaluation and clinical anticipation. HRMS should be suspected in any child with obstructive jaundice. Once diagnosis is established, multidisciplinary treatment is the best management strategy and it has proved better surgical outcome and long term survival.
authors.affiliation: Gastroenterology Surgical Center, General Surgery Department, Mansoura University, Egypt.
authors.forename: Mohamed Abd
authors.initials: MA
authors.lastname: Elwahab
authors.affiliation: Gastroenterology Surgical Center, General Surgery Department, Mansoura University, Egypt. Electronic address: hosam-eldin@hotmail.com.
authors.forename: Hosam
authors.initials: H
authors.lastname: Hamed
authors.affiliation: Gastroenterology Surgical Center, General Surgery Department, Mansoura University, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Shehta
authors.affiliation: Gastroenterology Surgical Center, General Surgery Department, Mansoura University, Egypt.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Ali
authors.affiliation: Pathology Department, Mansoura University, Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Zalata
keywords: Choledochal cyst; Hepatic cyst; Rhabdomyosarcoma