Laparoscopic marsupialization of a congenital simple liver cyst: a case report

Introduction Congenital hepatic cysts are rare and usually asymptomatic in infants and children, with an estimated postnatal incidence of 2.5%. Case presentation A 26-year-old pregnant woman with no relevant medical history underwent routine prenatal ultrasound at 36.3 weeks of gestation, which revealed a well-circumscribed anechoic cystic lesion in the right fetal hypochondrium measuring 5.6 × 4.7 × 6.8 cm. Cesarean section at 38 weeks resulted in the delivery of a male newborn weighing 3.1 kg, with Apgar scores of 8 and 9 and a Silverman score of 0. Anthropometric measurements were appropriate for gestational age, and physical examination revealed no abnormalities. Postnatal ultrasound performed on the 3rd day of life demonstrated a cystic lesion measuring 6.5 × 4.0 × 4.5 cm within the right hepatic lobe with posterior acoustic enhancement and a thin internal septation. Contrast-enhanced computed tomography performed on the 7th day of life confirmed a subcapsular cystic lesion (7.9 × 7.7 × 5.0 cm in size) causing hepatomegaly and a mass effect on adjacent organs. Given the large size of the lesion and favorable surgical accessibility, laparoscopic marsupialization was performed on the 20th day of life using a three-port approach and ultrasonic shears. Histopathological analysis confirmed a simple hepatic cyst lined by cuboidal epithelium with mild inflammatory infiltrate. The patient remained asymptomatic and free of recurrence during 2 years of follow-up. Conclusion Laparoscopic marsupialization appears to be a safe and effective treatment option for congenital simple hepatic cysts that are close to the liver capsule.