Hilar Fibropolycystic Liver Disease of Unknown Etiology: A Revelation from the Explant Liver

Abstract

Fibropolycystic diseases of the liver comprise a spectrum of disorders affecting bile ducts of various sizes and arise due to an underlying ductal plate malformation (DPM). We encountered a previously unreported variant of DPM, the hilar fibropolycystic disease which we diagnosed in the explant liver. A 2-year-old boy was referred for liver transplantation with a diagnosis of biliary atresia (BA) and failed Kasai portoenterostomy (KPE). He had cirrhosis with portal hypertension along with synthetic failure indicated by coagulopathy and hypoalbuminemia. The child underwent liver transplant successfully. The explant liver had fibropolycystic disease confined to the perihilar liver and hilum. No pathogenic mutation was detected by whole exome sequencing. Fibropolycystic liver disease may represent a peculiar anatomical variant, which can be diagnosed by careful pathological examination of the explant liver. The neonatal presentation of hilar fibropolycystic liver disease can be misdiagnosed as BA.

Keywords

liver transplantation - explant pathology - Hilar fibropolycystic liver disease - ductal plate malformation

Authors' Contributions

J.M. and N.S. collected the clinical data and compiled the manuscript. M.V. reported histopathological analysis and reporting. A.H., M.S.R., and I.K. did the proofreading. Mohamed Rela participated in critical revision and final approval of the draft to publish. M.R. participated in critical revision and final approval of the draft to publish.

Publication History

Received: 08 July 2020

Accepted: 13 August 2020

Article published online:
28 September 2020

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