Laparoscopic excision of a ciliated hepatic foregut cyst in a child: A case report and review of the literature

Abstract

IntroductionCiliated hepatic foregut cysts (CHFC) are rare congenital hepatic lesions derived from the embryonic foregut. Because of potential transformation to squamous cell carcinoma in adulthood, the mainstay of therapy is surgical resection. To our knowledge, we report the first case of CHFC in a child that was successfully excised laparoscopically.Presentation of caseWe report a case of a 4-year-old boy that was diagnosed with an asymptomatic 5-cm liver cyst. After surveillance for 3 years, the cyst grew to 7 cm at which time it was successfully resected laparoscopically. The pathology was consistent with CHFC.DiscussionThere have been few previous reports of CHFCs in children, all of which described excision via a laparotomy. This is the first case report of laparoscopic resection of CHFC in a child.ConclusionThis case report suggests that laparoscopy may be safe and effective for resection of CHFCs with favorable anatomy such as peripheral location and noninvolvement of key vascular and biliary structures.

Congenital Hepatic Cyst

“…For older patients, symptoms may include abdominal pain, nausea, and vomiting and rarely obstructive jaundice or portal hypertension. 6 …”

“…Malignant transformation of a congenital hepatic cyst is extremely rare, and the only recognized risk factor for this transformation is a cyst size greater than 12 cm. 4 , 6 …”

A ciliated hepatic foregut cyst mimicking hydatid cyst treated with laparoscopic surgery; a case-report and review of literature

“…Laparoscopic surgical approach is a feasible option for resection of CHFC given that the cyst wall is thick enough to be excised from the hepatic parenchyma and the lesion is situated on the surface of the liver. A few reports of laparoscopic CHFC resection have been documented in the literature [18] , [19] , [20] , [21] , [22] , which all showed favorable outcomes without any major complications. However, lesions that are located centrally or posteriorly, or those that involve major biliary or vascular structures, are considered as relative contraindications for laparoscopic surgery due to the increased technical difficulty associated with their excision [10] .…”

A Rare Case of Symptomatic Ciliated Hepatic Foregut Cyst in a 17-Year-Old Female

“…Previously published reports show that there have been approximately 100 cases during the last 150 years, in only a few cases of which patients were symptomatic [ 6 ]. The most common presentation of CHFC is asymptomatic, and the lesion is generally found incidentally during routine radiologic imaging, surgery, or autopsy [ 14 ]. The mean age of diagnosis is 50 years, with a slight increase in male predominance [ 6 , 15 ].…”