Ann Hepatobiliary Pancreat Surg.  2017 Aug;21(3):107-113. 10.14701/ahbps.2017.21.3.107.

Clinicopathological features and post-resection outcomes of biliary cystadenoma and cystadenocarcinoma of the liver

• Jwa EK
• Hwang S

• KMID: 2389986
• DOI: http://doi.org/10.14701/ahbps.2017.21.3.107

Abstract

BACKGROUNDS/AIMS
Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) account for 5%-10% of liver cystic diseases. In this study, we analysed the clinical presentation and surgical management of patients with BCA and BCAC.
METHODS
We retrospectively analysed the medical records of 23 BCA and 7 BCAC cases diagnosed between January 2007 and December 2013.
RESULTS
There was a statistically significant difference in age (p=0.044) and sex (p=0.048) between BCA and BCAC groups. In the BCA group, 17 patients showed no symptoms (74%), 5 had abdominal pain (22%) and 1 showed abdominal distension (4%). In the BCAC group, two patients were without any symptoms (29%), three had abdominal pain (43%), one showed abdominal distension (14%) and one had fever and chills (14%). The cystic lesion size was widely variable; thus, there was no statistical difference (p=0.84). Complete resection was performed in all patients with BCA and BCAC. No tumour recurrence developed in patients with BCA. In patients with BCAC, 1-, 3- and 5-year disease-free survival rates were 100%, 85.7% and 57.1%, respectively, and 1-, 3- and 5-year overall patient survival rates were 100%, 100% and 75.0%, respectively.
CONCLUSIONS
It is difficult to distinguish between BCA and BCAC via clinical manifestations and diagnostic imaging findings. Surgical resection is the treatment of choice for BCA and BCAC, and patient prognosis after complete resection was very favourable.

Keyword

Cholangiocarcinoma; Resection; Bile duct; Malignant change; Premalignant lesion

MeSH Terms

Abdominal Pain
Bile Ducts
Chills
Cholangiocarcinoma
Cystadenocarcinoma*
Cystadenoma*
Diagnostic Imaging
Disease-Free Survival
Fever
Humans
Liver*
Medical Records
Prognosis
Recurrence
Retrospective Studies
Survival Rate

Figure

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  Fig. 1 Preoperative computed tomography (CT) findings and gross photographs of the surgical specimens in patients with intrahepatic biliary cystadenoma. (A) A 3 cm-sized cyst is located in the left liver; (B) a 5 cm-sized multilocular cystic lesion with calcification and fat component is located in the left medial section; (C) a 12 cm-sized unilocular cyst with old haemorrhage and foreign body reaction is located in the right liver; (D) a 13 cm-sized unilocular cyst with extensive erosion and degeneration is located in the right liver; (E) a 15 cm-sized large unilocular cyst is located in the centre of the liver; and (F) a 19 cm-sized huge unilocular cyst is located in the right liver.

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  Fig. 2 Preoperative computed tomography (CT) findings and gross photographs of the surgical specimens in patients with intrahepatic biliary cystadenocarcinoma. (A) A 12 cm-sized cyst with multiple septae and friable polypoid mass is located in the medial section; (B) a 12 cm-sized unilocular cystic lesion with multifocal polypoid nodules is located in the right liver; and (C) a 4 cm-sized cystic mass of mucinous type is located in the left liver. This lesion is connected with the left hepatic duct, resulting in diffuse dilatation of the biliary system.

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  Fig. 3 Distribution of cystic tumour volume according to computed tomography volumetry. Blank circles indicate biliary cystadenoma cases and solid circles indicate biliary cystadenocarcinoma cases.

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  Fig. 4 Disease-free (A) and overall (B) patient survival curves of patients with intrahepatic biliary cystadenocarcinoma.

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