Hepatic mesothelial cyst in an infant with Beckwith-Wiedemann syndrome and omphalocele – a case report

A mesothelial cyst related to the liver is extremely rare in newborns and infants; it may be overlooked by physicians in the differential diagnosis process. Solitary cystic lesions are usually benign, and “watch and wait” management is often acceptable. However, in the case of clinical symptoms, diagnostic uncertainties, or increased risks of malignancy, surgical resection of the cyst with biopsy and histopathological examination becomes necessary. We present the case of an infant with Beckwith–Wiedemann syndrome (BWS) and omphalocele who postnatally developed a rapidly enlarging hepatic mesothelial cyst. The lesion was not identified during the initial abdominal exploration performed for the omphalocele and required open surgical resection when the infant was 2.5 months of age because of symptomatic expansive growth. A mesothelial cyst related to the liver is a very rare diagnosis during childhood. According to the available literature, only two such cases associated with Beckwith–Wiedemann syndrome have been reported to date. Although laparoscopic removal is currently preferred for abdominal cysts detected early, herein, we discuss the complexity of management in a syndromic patient who underwent open surgical resection.