Robotic left hepatectomy for the management of mucinous cystic neoplasm of the liver with atypical presentation inside the biliary tract: a case report

Mucinous cystic neoplasm of the liver (MCN-L) is a rare epithelial tumor with ovarian-like stroma (OLS), accounting for less than 5% of hepatic cysts. While usually confined to the liver, MCN-L rarely invades the biliary tract, complicating diagnosis and treatment. This case report describes a 53-year-old woman with recurrent cholangitis after robotic hepatic resection for MCN-L. Imaging revealed a lesion in the bile ducts, initially suspected to be intraductal papillary neoplasm of the bile duct (IPNB). Robotic left hepatectomy using the Da Vinci platform was performed, and intraoperative findings confirmed an intraductal pedunculated mass. Histopathology identified MCN-L with OLS invading the biliary tract. The patient recovered uneventfully and was discharged on postoperative day two. Although rare, MCN-L with biliary invasion can mimic IPNB. Robotic surgery provides a minimally invasive solution, emphasizing the importance of early detection and intervention for optimal outcomes.