A Case of Solitary Hepatic Cyst with Accessory Sulci of Liver

Abstract

Hepatic cystic lesions are rare accidental findings on imaging techniques and present a diagnostic challenge to the treating physician. They may range from a simple serous cyst to a complex heterogenous malignant cyst. However, the incidence of hepatic cysts is very less and hence is usually overlooked in radiological studies. Accessory grooves or fissures are frequently found on the hepatic surface and can cause diagnostic dilemma among radiologists and surgeons. Some accessory fissures might serve as guides during hepatectomy as they may separate hepatic segments. During routine dissection, we found a peculiar liver with a single cystic lesion filled with a white cheesy thick viscous material, several accessory fissures and an abnormal tissue band bridging the fissure for ligamentum teres hepatis. Histological study of the cyst wall and the abnormal band was also performed using routine and special staining techniques. The current report could alert radiologists and surgeons about various causes, radiological findings and surgical appearance of some asymptomatic liver cysts. Common variations in the external appearance and anomalies of the lobes and fissures of the liver are also reviewed here; the knowledge of which may minimize misdiagnosis or over diagnosis of liver diseases.

Keywords

• accessory fissure
• ligamentum teres hepatis
• quadrate lobe