312 Giant Hepatic Cyst Misdiagnosed as Pancreatic-Pseudocyst: A Case Report

Background A hepatic cyst is a benign hepatic tumor that is usually asymptomatic with normal liver function tests. The diagnosis of hepatic cyst is sometimes incidental on exploratory laparotomy as misdiagnosis may occur upon radiological investigations. Different modalities of treatment of symptomatic cysts include percutaneous aspiration, injection of sclerosing agents, laparoscopic or open fenestration, and surgical cystectomy. Aim To highlight clinical and radiological challenges in the diagnosis of hepatic cysts and different management modalities. Case We present a case of a 3-year-old boy with an 8-month history of progressive abdominal distension. There was no history of jaundice or abdominal pain. No history of leg swelling or decreased urine output and no preceding abdominal trauma. A radiological assessment of pancreatic pseudocyst was made. Exploratory laparotomy revealed a giant hepatic cyst on the right and left lobe more on the anterior surface. The gallbladder was separate from the cyst. The cyst was completely excised and weighed 9kg. The histology report was in keeping with mesenchymal harmatoma. Conclusions A hepatic cyst is a benign tumor of the liver ranging from small to huge size causing compression of the adjacent structure. It is usually asymptomatic with rare malignant potential. A giant hepatic cyst poses a diagnostic radiological challenge leading to misdiagnosis which affects patient management. It is recommended that a giant hepatic cyst should be considered as a differential diagnosis of intra-abdominal masses.