An uncommon cause of ascites: spontaneous rupture of biliary cystadenoma

Abstract

Biliary cystadenomas are cystic hepatic tumours of biliary origin. Cystadenomas are often slow-growing benign tumours, but always harbour the risk of malignant transformation. Cystadenomas are often asymptomatic, but may present with abdominal pain and distension. Though suspected with cross-sectional abdominal imaging, definitive diagnosis almost always requires histology. Spontaneous rupture of cystadenoma had been reported three times in the medical literature to date, all presenting with peritonitis. Here we report a case of spontaneous intraperitoneal rupture of biliary cystadenoma presenting as ascites without peritonitis.

Intrahepatic biliary cystadenoma mimicking hydatid cyst of liver: a clinicopathologic study of six cases

“…It must be also remembered that sometimes these tumors can assume giant proportions [ 14 , 20 ]. Occasionally, these rare tumors can give rise to even more unexpected clinical presentations such as acute pancreatitis due to compression of the pancreas [ 22 ], ascites with or without peritonitis due to spontaneous intraperitoneal rupture [ 23 ], varicocele and so on [ 24 ]. Pathologists can misdiagnose these cysts as simple cysts or hydatid cysts if they fail to concentrate on the cyst lining and ovarian-type stroma.…”