medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2016, Number 3

<< Back Next >>

Ann Hepatol 2016; 15 (3)

Rare biliary cystic tumors: a case series of biliary cystadenomas and cystadenocarcinoma

Banerjee A, Shah SR Singh A, Joshi A, Desai D

Language: English
References: 15
Page: 448-452
PDF size: 381.06 Kb.


ABSTRACT

Cystic lesions of the liver are common and a major proportion is formed by parasitic cysts and simple cysts. Biliary cystic tumors (BCTs), namely biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC), are rare tumors which usually arise from the intrahepatic biliary tree. BCAs have malignant potential and are difficult to differentiate from BCAC pre-operatively on radiological imaging. Here we have presented 4 patients with BCTs and reviewed the literature pertaining to them.The data of four patients with BCA/BCAC diagnosed and treated at our institute were retrieved from our database and records were reviewed for age, sex, history, imaging, surgery, pathology and follow-up. Mean age of the patients was 53.5 years (range 30-71 years). Two male and two female patients presented with abdominal pain, of which one male patient had pancreatitis at diagnosis. Characteristic features were seen on pre-operative imaging (cystic lesions with internal septations) and biliary communication was identified in the patient with pancreatitis. Three patients were diagnosed with a BCA on final histology, while one patient had a BCAC. Following surgical resection, all the patients are asymptomatic and disease free with a mean follow-up of 24 months (range 10-40 months). In conclusion, BCTs should be suspected in the presence of a well-encapsulated, cystic hepatic lesion with internal septations. Although pre-operative distinction between BCA and BCAC is difficult, the lesion, whenever possible, should be completely resected as long-term outcomes are good, especially with BCA.


REFERENCES

  1. Caremani M, Vincenti A, Benci A, Sassoli S, Tacconi D. Ecographic epidemiology of non-parasitic hepatic cysts. J Clin Ultrasound 1993; 21: 115-8.

  2. Subramony C, Herrera GA, Turbat-Herrera EA. Hepatobiliary cystadenoma: a study of five cases with reference to histogenesis. Arch Pathol Lab Med 1993; 117: 1036-42.

  3. Terada T, Kitamura Y, Ohta T, Nakanuma Y. Endocrine cells in hepatobiliary cystadenomas and cystadenocarcinomas. Virchows Arch 1997; 430: 37-40.

  4. Läuffer JM, Baer HU, Maurer CA, Stoupis C, Zimmerman A, Büchler MW. Biliary cystadenocarcinoma of the liver: the need for complete resection. Eur J Cancer 1998; 34: 1845-51.

  5. Sutton CD, White SA, Berry DP, Dennison AR. Intrahepatic biliary cystadenoma causing luminal common bile duct obstruction. Dig Surg 2000; 17: 297-9.

  6. Teoh AY, Ng SS, Lee KF, Lai PB. Biliary cystadenoma and other complicated cystic lesions of the liver: diagnostic and therapeutic challenges. World J Surg 2006; 30: 1560-6.

  7. Mortele KJ, Ros PR. Cystic focal liver lesions in the adult: differential CT and MR imaging features. Radiographics 2001; 21: 895-910.

  8. Seo JK, Kim SH, Lee SH, Park JK, Woo SM, Jeong JB, Hwang JH, et al. Appropriate diagnosis of biliary cystic tumors: comparison with atypical hepatic simple cysts. Eur J Gastroenterol Hepatol 2010; 22: 989-96.

  9. Lewin M, Mourra N, Honigman I, Fléjou JF, Parc R, Arrivé L, Tubiana JM. Assessment of MRI and MRCP in diagnosis of biliary cystadenoma and cystadenocarcinoma. Eur Radiol 2006; 16: 407-13.

  10. Ferrell L. Benign and malignant tumors of the liver. In: Odze RD, Goldblum JR, Crawford JM (eds.): Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas. Saunders: 2004; p. 1015-6.

  11. Zen Y, Fujii T, Itatsu K, Nakamura K, Konishi F, Masuda S, Mitsui T, et al. Biliary cystic tumors with bile duct communication: a cystic variant of intraductal papillary neoplasm of the bile duct. Mod Pathol 2006; 19: 1243-54.

  12. Erdogan D, Kloek J, LamersWH, Offerhaus GJ, Busch OR, Gouma DJ, van Gulik TM. Mucinous cystadenomas in liver: management and origin. Dig Surg 2010; 27: 19-23.

  13. Thomas KT, Welch D, Trueblood A, Sulur P, Wise P, Gorden DL, Chari RS, et al. Effective treatment of biliary cystadenoma. Ann Surg 2005; 241: 769-73; discussion 773-5.

  14. Wheeler DA, Edmondson HA. Cystadenoma with mesenchymal stroma (CMS) in the liver and bile ducts. A clinicopathologic study of 17 cases, 4 with malignant change.Cancer 1985; 56: 1434-45.

  15. Soares KC, Arnaoutakis DJ, Kamel I, Anders R, Adams RB, Bauer TW, Pawlik TM. Cystic neoplasms of the liver: biliary cystadenoma and cystadenocarcinoma. J Am Coll Surg 2014; 218: 119-28.




2020     |     www.medigraphic.com