Biliary Cystadenoma and Cystadenocarcinoma of the Liver

Lee, Jae Hoon; Choi, Dong Ho; Lee, Kyeong Geun; Park, Hwon Kyum; Lee, Kwang Soo

Abstract

PURPOSE
Cystic neoplasms in the liver are rarely seen tumors. Biliary cystadenoma and cystadenocarcinoma constitute less than 5% of intrahepatic cysts originating from the bile duct. The clinicopathologic and radiologic findings are important to arrive at the proper diagnosis and treatment of intrahepatic biliary cystadenoma and cystadenocarcinoma. The aims of this study were to characterize the clinical and pathologic aspects of these lesions, and also to discuss the treatment and prognosis of biliary cystadenoma and cystadenocarcinoma. METHODS: We reviewed the clinical records of six patients who had intrahepatic biliary cystadenoma and cystadenocarcinoma and who had undergone operations from January, 1986 to June, 2002 at Hanyang University Hospital. RESULTS: Primary biliary cystadenoma and cystadenocarcinoma of the intrahepatic biliary systems are rarely seen tumors. Biliary cystadenoma mainly affected women, and this was a different gender preponderance than was seen for biliary cystadenocarcinoma. We found no signs or symptoms that were specific for either of these tumors, and the diagnoses were usually made by abdominal CT and abdominal ultrasonography. These tumors were usually large, multilocular and cystic in appearance. The pathologic findings revealed multiple cystic masses lined with cuboidal to columnar epithelium. The nature of the cystic fluid was usually the mucous type. Of the 6 patients in whom the lesions were completely excised, 4 of the patients are alive. The other 2 patients died of old age and distant metastasis, respectively. CONCLUSION: Surgical resection of the tumor, including a margin of surrounding normal liver parenchyma, was the only curative method. If the tumor is confined in the liver, complete surgical excision yields an excellent prognosis. Complete resection of a biliary cystadenoma and radical resection of a biliary cystadenocarcinoma seem to offer these patients a chance for long-term survival.