Polycystic liver disease.

A 57-year-old woman with a past history of serous ovarian cystadenoma was admitted to hospital complaining of progressive abdominal bloating for the last six months. Physical examination revealed an increase in abdominal perimeter. The rest of the physical examination was normal. Alkaline phosphatase and gamma-glutamyl-transpeptidase were marginally raised, while the rest of the liver function panel was normal. An abdominal contrast-enhanced computerized tomography (CT) scan (Figs. 1 and 2) demonstrated polycystic liver disease with a giant cyst (22 x 19 cm) and a right kidney that was pushed towards the pelvis. Serologic tests for echinococcal antigens were negative. The giant cyst was aspirated under laparoscopic guidance with 5 liters of clear fluid withdrawn. A laparoscopic fenestration was performed without complications. Cystic fluid cultures were negative. A histopathological analysis of wall fragments confirmed the typical findings in a simple cyst. Currently, the patient is asymptomatic.