A case of biliary cystadenocarcinoma with multicentric arterioportal shuntings that disappeared after total excision of the entire cyst.

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A 53 year-old woman was admitted to our hospital because of skin itching. The liver function tests revealed the marked elevation of Al-P and γ-GTP. Ultrasound and CT scan showed a huge liver cyst with a mural nodular lesion and dilated intrahepatic bile ducts. Angiography showed the compression of the portal vein and multicentric arterioportal shuntings in the peripheral region of the liver. The histological finding of the cyst was biliary cyst adenocarcinoma. After the excision of the cyst, the level of Al-P and γ-GTP was decreased, and the disappearance of the portal vein compression and arterioportal shuntings was shown by angiography. In this case, a huge liver cyst caused the compression of the biliary and portal system, resulting in the obstructive pattem on liver function tests and arterioportal shuntings of transsinusoidal type. Ultrasound and CT scan were useful to detect the neoplastic finding in this liver cyst.