Submit
     
Case Report
 
Rapid regrowth of a large hepatic cyst following spontaneous rupture
Tomoki Nakajima1, Manabu Okajima1, Akiko Shibuya1, Junko Yamaoka1, Toshiaki Nakashima1, Yoshito Itoh2
1MD, Department of Medicine, Saiseikai Kyoto Hospital, Nagaoka-kyo, Kyoto, Japan.
2MD, Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan.

doi:10.5348/ijcri-2014-02-466-CR-18

Address correspondence to:
Tomoki Nakajima
Department of Medicine, Saiseikai Kyoto Hospital
8-Minamihirao, Imazato, Nagaoka-kyo City
Kyoto 617-0814
Japan
Phone: +81-75-955-0111
Fax: +81-75-954-8255
Email: tomnaka@silver.ocn.ne.jp

Access full text article on other devices

  Access PDF of article on other devices

[HTML Full Text]   [PDF Full Text] [Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar]


How to cite this article
Nakajima T, Okajima M, Shibuya A, Yamaoka J, Nakashima T, Itoh Y. Rapid regrowth of a large hepatic cyst following spontaneous rupture. International Journal of Case Reports and Images 2014;5(2):174–179.


Abstract
Introduction: Spontaneous rupture of a simple hepatic cyst is rare, and the clinical course after rupture is not fully known. We report a case of a huge hepatic cyst which rapidly regrew after spontaneous rupture.
Case Report: A 74-year-old male underwent further examination and follow-up of a huge hepatic cyst which was first detected at annual health check. On his first visit, the cyst was 10×9 cm in size. During the first 7 years of follow-up, the cyst gradually grew to 18×14 cm. Eight years after his first visit, ultrasonography showed that the huge hepatic cyst was without intracystic echogenic content. However, nine days after that, a computed tomography (CT) scan revealed that the cyst had nearly disappeared with remnant minimal cystic fluid and ascites although the patient was asymptomatic. Subsequently, within one month, the patient complained of back pain, and another CT scan showed that the cyst rapidly regrew to 13×10 cm in size. The cyst gradually regressed after sequential intracystic injection of absolute ethanol and minocycline.
Conclusion: The rapid disappearance of the cyst was considered to be due to intraperitoneal rupture. The patient was asymptomatic just after rupture, but complained of back pain possibly because the regrowth was rapid. In some cases of huge hepatic cyst, rupture may be dismissed because it can be asymptomatic and the cystic fluid may have possibly already accumulated by the time symptoms appear.

Keywords: Spontaneous rupture, Hepatic cyst, Absolute ethanol, Minocycline


[HTML Full Text]   [PDF Full Text]
Author Contributions
Tomoki Nakajima – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Manabu Okajima – Conception and design, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Akiko Shibuya – Conception and design, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Junko Yamaoka – Conception and design, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Toshiaki Nakashima – Conception and design, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Yoshito Itoh – Conception and design, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© Tomoki Nakajima et al. 2014; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)



About The Authors

Tomoki Nakajima is the Assistant Director at Saiseikai Kyoto Hospital, Nagaoka-kyo City, Japan. He is a hepatologist and his research interests include basic and clinical hepatology and gastroenterology. He has published some research papers concerning hepatocarcinogenesis, metabolic liver disease and educational clinical cases in academic journals.



Manabu Okajima is the Chief physician at Department of Medicine, Saiseikai Kyoto Hospital, Nagaoka-kyo City, Japan. He is an endoscopist and his research interest includes interventional endoscopy.



Akiko Shibuya is the Chief physician at Department of Medicine, Saiseikai Kyoto Hospital, Nagaoka-kyo City, Japan. She is a hepatologist and her research interests include clinical hepatology and gastroenterology.



Junko Yamaoka is the Chief physician at Department of Medicine, Saiseikai Kyoto Hospital, Nagaoka-kyo City, Japan. She is a hepatologist and her research interests include clinical hepatology and gastroenterology.



Toshiaki Nakashima is the Director at Saiseikai Kyoto Hospital, Nagaoka-kyo City, Japan. He is a hepatologist and his research interests include basic and clinical hepatology and gastroenterology.



Yoshito Itoh is Professor of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan. He is a hepatologist and his research interests include basic and clinical hepatology and gastroenterology.