Bile duct cystadenoma (8161) or biliary cystadenoma is a slow-growing tumour arising from bile ducts of the liver. The presence of endocrine cells in the tumour also indicates its origin from the glands surrounding the bile ducts. The incidence is 1–5 in 100,000 people. Females are affected more than males at 9:1 ratio. Mean age of presentation is at 45 years old. About 30% of biliary cystadenoma can progressively become malignant over time.[1]