Multiple biliary hamartomas (MBHs), or the von Meyenburg complexes, are cystic malformations of the small interlobular bile ducts that arise from the cranial portion of an endodermal diverticulum during embryologic development. Prevalence is under 1%, with few cases described, and they can be confused with other cystic liver tumors. MBHs are generally asymptomatic and benign but can be associated with cholangiocarcinoma, thus CA 19-9 determination and lesion follow-up are recommended.
A 49-year-old woman with an unremarkable medical history, was asymptomatic and had normal liver function tests. She presented with multiple small liver lesions, with low attenuation, as an incidental finding on the upper abdominal axial projection of a chest computed tomography (CT) scan (Fig. 1). Abdominal magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) identified numerous round lesions, 2×2mm to 15×12mm in diameter, hypointense on T1, hyperintense on T2, not communicating with the biliary tree (Fig. 2a and b). The lesions were evenly dispersed in both liver lobes, with a "starry sky" appearance (Fig. 3). Given the clinical characteristics and typical MR and MRCP images, the diagnosis of MBH was made. No histologic confirmation was requested.
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The authors declare that even though no personal data that could identify the patient were published in the present article, informed consent was obtained from the patient, and the document is in the possession of the corresponding author.
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Please cite this article as: Bravo-Acosta M, Rosendo-Namías J, Martínez-Méndez D. Hamartomatosis biliar múltiple: «imagen en cielo estrellado». Revista de Gastroenterología de México. 2021;86:191–192.