PMC6195646_01
(A) T2-Weighted magnetic resonance cholangiopancreatography (MRCP) showing severe diffuse intrahepatic biliary ductal dilatation with multiple cyst-like dilated areas of the intrahepatic biliary tree. (B) MRCP image concerning for left common hepatic duct stones (arrow).
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F1
T2-Weighted magnetic resonance cholangiopancreatography (MRCP) showed severe intrahepatic biliary ductal dilatation with multiple cystic collections in the left lobe of the liver (Figure 1).
Endoscopic retrograde cholangiography showing soft tissue mass (arrow) at the bile duct bifurcation with upstream biliary dilatation.
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F2
Endoscopic retrograde cholangiography (ERCP) revealed a large filling defect with smooth borders at the bifurcation with marked upstream dilatation of the left intrahepatic ducts and mild dilation of right intrahepatic ducts (Figure 2).
Cholangioscopy showing soft tissue mass with normal overlying mucosa at the proximal common bile duct.
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V1
The patient subsequently underwent left hepatic lobectomy with resection of bile duct mass and hepatico-jejunostomy (Figure 3).
Gross specimen showing (A) a polyp within the bile duct (arrow) and (B) a multiloculated smooth-walled cyst.
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F3
Histologic examination revealed a 2.6-cm benign adenofibroma and a 5.5-cm benign multiloculated hepatobiliary mucinous cystic neoplasm with subepithelial ovarian stroma within the left hepatic duct system (Figure 4).