A 6-year-old boy is brought to the office for an annual wellness check. He has no symptoms. Medical and family history are unremarkable. Vital signs are within normal limits. The patient's height and weight are both appropriate for his age. On examination, an abdominal mass is palpated in the right upper quadrant. Laboratory evaluation, including bilirubin, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase, is unremarkable. A common bile duct cyst is identified by abdominal ultrasound and is confirmed by MR cholangiopancreatography.

Which of the following is the best next step in management?

A. Serial abdominal ultrasounds to screen for cirrhosis
B. Serial abdominal ultrasounds to screen for malignancy
C. Surgery now to prevent cirrhosis
D. Surgery now to prevent malignancy

The best next step in the management of a common bile duct cyst identified by abdominal ultrasound is Surgery now to prevent malignancy. A common bile duct cyst is a congenital dilation of the biliary tree that can lead to complications such as cholangitis and malignancy. Early surgical intervention is recommended to prevent the risk of malignancy.

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