Hepatic epidermoid cyst in a pediatric patient: A case report

Abstract

Introduction: Hepatic epidermoid cysts are uncommon benign liver lesions that infrequently manifest in pediatric populations. Out of the limited reported cases, only 11 are pediatric. Despite their rarity, their potential for various clinical presentations necessitates careful examination and understanding. Case presentation: A 10-year-old female with a history of constipation presented with persistent abdominal pain. Initial suspicions, influenced by her travel history to Dubai and interactions with camels and dolphins, led to considerations of infectious etiologies like echinococcosis. Imaging revealed a complex cystic mass in the liver's right lobe, measuring 4.5 x 5.2 × 6.0 cm. Despite a range of diagnostic efforts, including imaging with ultrasound and MRI as well as infectious disease and gastroenterology consults, the cyst's nature remained ambiguous. After interventional radiology (IR) drainage, symptoms continued and the cyst remained visible on imaging, but cytology of the fluid revealed it to be a benign epidermoid cyst. Surgical intervention, specifically a laparoscopic deroofing, was performed, resulting in symptom relief and prevention of potential future complications. Six months post-surgery, no further dominant cyst was present. Conclusion: This case accentuates the diagnostic complexities surrounding hepatic epidermoid cysts in pediatric patients. A multidisciplinary approach, along with surgical intervention, proved instrumental in diagnosing and managing this rare condition. It reinforces the importance of careful examination and collaboration in managing atypical pediatric liver conditions.