A 51-year-old woman with a known history of polycystic disease of the liver and kidneys presented with jaundice and abdominal pain. A Tc-99m mebrofenin hepatobiliary scan showed a 'Cupid-heart' shaped area of uptake in the right iliac fossa and pelvic cavity, which persisted throughout the study. CT scan images showed replacement of the left lobe and most of the right lobe of the liver with multiple-sized cysts, except for the inferior parts allowing for the unusual appearance. The scintigraphic diagnosis of cholestatic intrahepatic biliary obstruction was confirmed on laparotomy. This was associated with extra hepatic obstruction treated with hepaticojejunostomy.
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