Biliary cystadenoma presenting as hilar intraluminal cyst causing episodic biliary obstruction

Introduction: Biliary cystadenomas are rare benign cystic lesions of biliary origin with potential of malignancy. Mostly occurring in women (90%) with non-specific symptoms. Case Report: We presented a very rare case of biliary cystadenoma in hilar region causing episodic biliary obstruction. A 60-year-old female with episodic obstructive jaundice was evaluated and diagnosed as having cystic lesion near the hilum of liver. With differential diagnosis of biliary cystadenoma or hydatid cyst, she underwent laparotomy. Intraoperatively the cystic lesion was found in the segment IVb with communication into the hilar region as pedunculated polypoid lesion, which was occluding the lumen causing biliary obstruction. The cystic lesion in segment IVb was excised and the communicating polyp with the hilum was removed along with T tube drainage of common bile duct. Her postoperative period was uneventful and T Tube was removed during the follow up. She was symptom free and anicteric during the follow up period. Conclusion: Biliary cystadenoma should be suspected when radiologic imaging studies suggest a multilocular cystic hepatic lesion, especially in middle aged women.