Malignant transformation of biliary adenofibroma combined with benign lymphadenopathy mimicking advanced liver carcinoma: A case report

Abstract

BACKGROUND Biliary adenofibromas (BAFs) are rare primary hepatic neoplasms, some of which can potentially undergo malignant transformation. Here, we describe a rare case of malignant transformation of BAF. CASE SUMMARY A 51-year-old female was referred to our hospital with epigastric pain. Computed tomography showed a solitary liver mass combined with the enlargement of multiple mediastinal and cervical lymph nodes, clinically mimicking a liver carcinoma with extensive lymph node metastasis. However, core needle biopsy suggested BAF with malignant transformation. Finally, the patient underwent curative resection of the neoplasm and was recurrence-free for 12 mo. CONCLUSION Our case serves as an example of a rare manifestation of BAF. Our report and the previously published experience, reinforce that curative resection should be considered the primary treatment for BAFs with malignant transformation, leading to a favorable prognosis.

Imaging Features of Biliary Adenofibroma With Malignant Transformation: A Case Report and Literature Review

“…Delayed enhancement of benign BAF may be related to a high content of fibrous stroma [1]. Among the cases that mentioned the DWI sequence, five showed obvious diffusion restriction, and the pathology suggested malignant transformation [6,11,13,16,17]. In summary, a lobulated and multiseptated cystic-solid mass located under the hepatic capsule, with the separation obviously enhanced, can help radiologists associate BAF.…”

“…Some lesions have obvious solid components, accompanied by enhanced arterial phase enhancement, of which nine cases described relatively low signal on the venous and delay phases. The pathological diagnosis showed malignant transformation in seven cases [3,6,10,11,13,16,17], which may be related to complex papillary, cribriformlike, back-to-back architecture, and less fibrous tissue. Delayed enhancement of benign BAF may be related to a high content of fibrous stroma [1].…”

“…We performed a detailed analysis of imaging information from previous cases (see Appendix) in which the median size of the lesion was 6.55 and ranged from 0.7 to 20 cm, which was mainly located under the capsule (50%) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Most of the lesions were multilobulated and multiseptated cystic.…”