Primary biliary cystadenocarcinoma perforating the duodenum and left intrahepatic biliary tree - mimicking a hydatid cyst

We report the case of a 76-year-old woman with biliary cyst;adenocarcinoma perforating the left biliary tree and exhibiting intratumoral gas bubbles r esulting from invasion of the duodenum. The clinical history included subfe brile temperatures of 3 months duration, and pains associated with an abdom inal mass in the right upper quadrant. Blood tests showed leucocytosis, and radiological studies revealed the features of a partially calcified septat ed tumor with nodular components combined with multiple gas-fluid levels, m imicking an infected hydatid cyst. Intraoperative ultrasonography, cholangi ography and frozen section histology were necessary to prove the malignant nature of this cystic tumor. Provided that complete resection with strict a dherence to oncological precepts is possible, the prognosis of cystadenocar cinoma is better than in hepatocellular or cholangiocellular carcinoma.