title: A cystic, septated lesion in the liver with unusual diagnosis.
abstract: A 51-year-old male patient from Iraq presented with symptoms of right upper-quadrant abdominal pain. Imaging showed a 9 cm, lobulated cystic lesion in the right liver lobe with thin septations, suggestive of a hydatid cyst. Although serology for hydatid disease was negative, the cystic lesion was treated by percutaneous drainage. Owing to persisting symptoms, he was re-evaluated showing the same cystic lesion unchanged. On the presumptive diagnosis of a cystadenoma or cystadenocarcinoma, patient underwent laparotomy. A solitary, cystic lesion was found that was removed by local excision. Macroscopical examination revealed a multilocular, septated tumour. Histopathological assessment showed lining of the cysts with epithelioid cells that showed immunohistochemical features consistent with a mesothelial origin; the pathology findings are consistent with an adenomatid tumour; in the differential diagnosis a benign multicystic mesthelioma was also considered. These are rare cystic lesions in the liver of which only few cases have been described in literature.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Iteke
authors.initials: I
authors.lastname: van Seventer
authors.affiliation: Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Joanne
authors.initials: J
authors.lastname: Verheij
authors.affiliation: Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Saffire
authors.initials: S
authors.lastname: Phoa
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: van Gulik
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D018254:Adenomatoid Tumor / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D003560:Cysts / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D007493:Iraq; D008099:Liver / Q000000981:diagnostic imaging / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography