Extrahepatic Biliary Cystadenomas and Cystadenocarcinoma

Abstract

Extrahepatic biliary cystadenomas can become malignant, and in this study, local surgical excision was associated with a 50% local recurrence rate. Sleeve resection with negative histologic resection margins followed by bilioenteric reconstruction, therefore, is recommended.

Intrahepatic Biliary Cystadenoma Causing Luminal Common Bile Duct Obstruction

“…Since this time several treatment strategies have been suggested: simple enucleation [22]; local excision either with a cuff of bile duct or liver, and radical excision including hemi-hepatectomy if appropriate. However, as there are number of reported cases it has become apparent that these tumours have low malignant potential and unless excised completely tend to reoccur [1, 2, 8, 23]. The largest reported series of 15 cases is by Lewis et al who conclude that whilst formal lobar resection is frequently carried out, local complete excision is just as effective provided the neoplasm is entirely removed and is associated with low rates of morbidity [4].…”

“…It is extremely rare for an intrahepatic cystadenoma to extend into the common bile duct; less than 10 cases have been reported in the medical literature [3, 4, 5, 6]. The majority of biliary cystadenomas occur in the right lobe of the liver [7], less so in the left lobe and rarely in the extrahepatic biliary tree [8]. …”

“…Presentation is frequently non-specific; patients may complain of abdominal pain, anorexia, nausea. Liver function tests are frequently abnormal, extrahepatic lesions tend to present with obstructive jaundice [1, 2, 8]. …”

Cystic Neoplasms of the Liver: Biliary Cystadenoma and Cystadenocarcinoma

“…(7-11) While 10% of reported BCT originate in the extrahepatic biliary tree, the overwhelming majority arises from the intrahepatic biliary system. (12-15) BCT are typically slow growing lesions with a reported size that can range in diameter from 1.5 to 35 cm. (6, 10, 16, 17)…”

“…(19, 24) Obstructive jaundice and cholangitis are rare and do not correlate with malignant disease and typically occur with extrahepatic BCT. (12, 25-30) Hemorrhage and cyst rupture are other recognized, yet very uncommon, presenting complications of these lesions. (31-33)…”