Hepatobiliary cystadenomas and cystadenocarcinomas: a report of 33 cases

Abstract

Clinical symptoms are unreliable for these diagnoses and their differential diagnosis. Imaging evaluations and CA19-9 are of value for the recognition of cystadenoma and cystadenocarcinoma, but not for their differential diagnosis. Any recurrence of liver cyst after surgery or other treatments should lead one to suspect one of these diseases. Invasive examination and percutaneous fine-needle aspiration cytology are not recommended. Complete excision or careful enucleation should be the first treatment choice for a better prognosis.

Cystic Neoplasms of the Liver: Biliary Cystadenoma and Cystadenocarcinoma

“…(18, 19, 21) The latter theory is supported by the multiple reports of benign epithelium within BCAC specimens. (8, 10, 18, 21, 22) For example, Devaney et al (10) reported malignant transformation in 6 of the 18 BCAC in their series as well as cytological atypia/dysplasia in a number of BCA.…”

“…(8, 16, 39) Septal thickening, papillary infolding, and mural nodules are characteristic of BCTs. (40, 41) BCAC is more likely to contain mural or septal nodules and papillary projections.…”

“…(33, 43) On CT, BCT lesions are isodense to water (less than 30 HU) with nodular areas enhancing with intravenous contrast. (8, 16, 30, 39, 47) Biliary duct dilatation, single cysts, and lesions in the left lobe of the liver can be predictive of BCT on CT.(48) In fact, multiple investigators have suggested that BCTs are more often located in the left hemi-liver and therefore BCT should be considered for suspicious cystic lesions in the left liver especially in the setting of an increase in alkaline phosphatase. (6, 7, 45, 48, 49) While there have been anecdotal reports on its potential usefulness in identifying malignancy with BCAC, no definitive conclusions can be made regarding the utility of PET-CT for BCTs.…”

“…(6, 7, 45, 48, 49) While there have been anecdotal reports on its potential usefulness in identifying malignancy with BCAC, no definitive conclusions can be made regarding the utility of PET-CT for BCTs. (8, 50)…”

A rare cause of dilated bile duct incidentally detected on imaging

“…Biliary tract tumours are rare entities, more common in women than in men; they can occur in gallbladders or extrahepatic ducts 3 4. They can be classified according to the morphology or histology types.…”