PGY3 Nikhil Gupta presented an interesting case of a young woman with no medical history who presented with a massive liver cyst which was initially empirically treated for echinococcal infection given the appearance of the cyst and her close contact with dogs, travel history to Australia and contact with kangaroos. The cyst was eventually resected and histology showed mucinous cyst neoplasm.
Differential diagnoses for hepatic cysts include simple cysts, polycystic disease, hydatid cysts, and neoplasms including cystadenomas, cystadenocarcinomas and less likely metastases.
-Cystadenomas (Mucinous cystic neoplasms) are rare cystic tumors that occur more commonly in women. Diagnosis requires histologic examination and treatment is resection.
Morning report pearl: Percutaneous aspiration of a suspected echinococcal cyst is avoided unless other diagnostics are inconclusive due to the potential for anaphylaxis and spread of infection.