Cystic Neoplasms of the Liver: Biliary Cystadenoma and Cystadenocarcinoma

Soares, Kevin C.; Arnaoutakis, Dean J.; Kamel, Ihab R.; Anders, Robert A.; Adams, Reid B.; Bauer, Todd W.; Pawlik, Timothy M.

doi:10.1016/j.jamcollsurg.2013.08.014

Cited by 157 publications

(196 citation statements)

References 86 publications

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“…However, hematological analysis and tumor markers are non-specific for distinguishing BCTs from other hepatic cystic masses (21,22). Given the suspected BCT, image-guided needle aspiration cytology or biopsy is not implemented, due to high false negative results and the risk of peritoneal dissemination (23). Furthermore, an elevated bilirubin concentration in the aspiration fluid cannot be considered as a conclusive parameter to discriminate bilomas from BCTs with bile duct communication (24,25).…”

Section: Discussionmentioning

confidence: 99%

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

Zhu

Wang

Jiao

et al. 2016

Molecular and Clinical Oncology

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Abstract. Gallbladder perforation (GBP) represents a rare, but potentially life-threatening, complication of acute cholecystitis. GBP is subdivided into three categories whereas the development of biloma is extremely rare. The present case study reports on a 40-year-old man with a 10-year history of calculus cholecystitis, who was referred to The First Affiliated Hospital of Nanjing Medical University (Nanjing, China) for the surgical treatment of an emerging massive hepatic entity with insidious symptoms and normal laboratory tests. A preoperative imaging study demonstrated the collection with internal septations and mural nodules, but no visible communication with the biliary system. Given the suspected biliary cystic tumor, a laparotomy was performed and the lumen was scattered with papillae. An intraoperative frozen section examination illustrated a simple hepatic cyst. Biochemical analysis of the collection and histopathology of the gallbladder and capsule substantiated the diagnosis of biloma formation due to GBP. The purpose of the present case report was to demonstrate how a pinhole-sized perforation with extravasation of unconcentrated bile from the gallbladder may result in insidious clinical presentation and an undetected leak site. According to the clinicopathological characteristics and composition, formation of biloma should be classified as type IV GBP. To differentiate bilomas with intracystic septations and mural nodules from BCTs is difficult via a preoperative examination, and the definitive diagnosis should be based on a histological examination. Laparotomy with frozen section examination may be the optimal approach in such a case.

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Section: Discussionmentioning

confidence: 99%

A giant and insidious subphrenic biloma formation due to gallbladder perforation mimicking biliary cystic tumor: A case report

Zhu

Wang

Jiao

et al. 2016

Molecular and Clinical Oncology

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“…2 The majority of cystadenomas and cystadenocarcinomas arise from the intrahepatic biliary tree, although about 10% of biliary cystic tumors have been reported to originate from extrahepatic bile ducts. 5 These tumors are typically slow growing but can range in size from 1.5 to 35 cm. 5 A combination of CT, MRI, and ultrasound combined with clinical features may more accurately differentiate complex biliary cysts.…”

Section: Discussionmentioning

confidence: 99%

“…5 These tumors are typically slow growing but can range in size from 1.5 to 35 cm. 5 A combination of CT, MRI, and ultrasound combined with clinical features may more accurately differentiate complex biliary cysts. 5 Biliary cystic tumors are typically multilocular on MRI and demonstrate a homogenous low-intensity T1 signal and a highintensity T2 signal.…”

Section: Discussionmentioning

confidence: 99%

“…5 A combination of CT, MRI, and ultrasound combined with clinical features may more accurately differentiate complex biliary cysts. 5 Biliary cystic tumors are typically multilocular on MRI and demonstrate a homogenous low-intensity T1 signal and a highintensity T2 signal. 5 The most common presenting symptoms are right upper quadrant pain, a palpable mass, or jaundice.…”

Section: Discussionmentioning

confidence: 99%

“…5 Biliary cystic tumors are typically multilocular on MRI and demonstrate a homogenous low-intensity T1 signal and a highintensity T2 signal. 5 The most common presenting symptoms are right upper quadrant pain, a palpable mass, or jaundice. Hemorrhage and cyst rupture have been reported in the literature, but are very uncommon.…”

Section: Discussionmentioning

confidence: 99%

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Biliary Cystadenocarcinoma: An Unusual Cause for Recurrent Hemobilia

Philip

Kamyab

Jacobs

2015

International Surgery

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Hemobilia is an uncommon presentation of biliary tract or pancreatic disease. The investigation and management of this clinical problem is challenging. We report on a case of biliary tract hemorrhage from an otherwise asymptomatic right lobe biliary cystadenocarcinoma and review the literature on this unusual presentation. Hemobilia from primary or secondary liver tumors is not frequently reported in the literature. Hemobilia in this setting is usually observed in association with an obvious liver mass or abnormal liver function tests. This is a report of a case of hemobilia as the primary presentation of a small right lobe cystadenocarcinoma. Literature on the incidence and treatment of hemobilia associated with liver tumors has been reviewed. Hemobilia is investigated and definitively treated with angiography. In our case, initial imaging was equivocal and the lesion was only demonstrated after rebleeding, requiring a second angiogram. Surgical resection of the mass was required for definitive control of bleeding. This case illustrates the difficulties of investigating and treating hemobilia caused by primary or secondary liver tumors. Cystadenocarcinoma of the liver is not a common tumor, and biliary tract hemorrhage as the primary presentation of this tumor in the absence of a significant mass or abnormal liver function tests has not been previously described.

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