, Volume 56, Issue 7, pp 1949-1953
Date: 29 Mar 2011

Ruptured Biliary Cystadenoma Managed by Angiographic Embolization and Interval Partial Hepatectomy

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Case Presentation and Evolution

A 56-year-old woman with abdominal pain worsening over several days presented to an outside hospital emergency department. A computed tomography (CT) of the abdomen and pelvis revealed a 19 × 14 × 14 cm heterogeneous central liver mass with solid and cystic components as well as calcifications. Free fluid consistent with hemoperitoneum was noted (Fig. 1). The patient reported a history of a 4.5-cm hepatic cyst diagnosed 5 years prior to presentation that had been percutaneously aspirated (Fig. 2). By her report, the cytology was benign and no further follow-up was recommended. On the basis of this history and presentation, she was transferred to Stanford University Medical Center for further management. Shortly after arrival, she developed hemorrhagic shock. She was resuscitated and taken to the interventional radiology suite for embolization to control bleeding. Angiographic imaging revealed areas of tumor neovascularity but no areas of active extravasat ...