Abstract
Intrahepatic biliary cystadenoma (IHBCA) is a rare type of liver tumor. There are no specific diagnostic methods for IHBCA, so its preoperative diagnostic rate is still fairly low. The aims of this study were to evaluate the clinical manifestations, diagnosis, and treatment of IHBCA. We retrospectively analyzed data from 14 patients treated in our hospital from January 2004 to April 2014. Eleven patients (78.6 %) were female, and the average age was 48.0 years (range 16–77 years). The most common clinical symptoms were abdominal discomfort (i.e., abdominal pain), reported in seven cases (50 %), and fullness after eating, reported in two cases (14.3 %). Jaundice was a less common symptom reported in one case (7.1 %). Four patients (28.6 %) were asymptomatic. Enhanced computed tomography (CT) scan showed multilocular or internal septations in 11 cases (78.6 %) and papillary projections or mural nodules on the cyst wall in one case (7.1 %). After injection of a contrast agent, the cyst walls or septations were slightly enhanced in nine cases (64.3 %). All 14 patients underwent surgical resection. Only one case showed recurrence (2 years postoperatively); the remaining 13 patients were recurrence-free. Intrahepatic biliary cystadenoma often occurs in middle-aged women. The main clinical symptoms are abdominal fullness with a sense of pain and jaundice. Enhanced CT is the main preoperative diagnostic method. Radical resection is the best treatment for IHBCA and can effectively prevent recurrence.
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Kazama S, Hiramatsu T, Kuriyama S, et al. Giant intrahepatic biliary cystadenoma in a male: a case report, immunohistopathological analysis, and review of the literature. Dig Dis Sci. 2005;50:1384–9.
Teoh AY, Ng SS, Lee KF, et al. Biliary cystadenoma and other complicated cystic lesions of the liver: diagnostic and therapeutic challenges. World J Surg. 2006;30:1560–6.
Florman SS, Slakey DP. Giant biliary cystadenoma: case report and literature review. Am Surg. 2001;67:727–32.
Rooney TB, Schofer JM, Stanley MD, Banks SL. Biliary cystadenoma of the gallbladder. AJR Am J Roentgenol. 2005;185:1571–2.
Pojchamarnwiputh S, Na Chiangmai W, Chotirosniramit A, et al. Computed tomography of biliary cystadenoma and biliary cystadenocarcinoma. Singap Med J. 2008;49:392–6.
Del Poggio P, Buonocore M. Cystic tumors of the liver: a practical approach. World J Gastroenterol. 2008;14:3616–20.
Senyüz OF, Numan F, Eroğlu E, et al. Hepatobiliary mucinous cystadenoma in a child. J Pediatr Surg. 2004;39:E6–8.
Vogt DP, Henderson JM, Chmielewski E. Cystadenoma and cystadenocarcinoma of the liver: a single center experience. J Am Coll Surg. 2005;200:727–33.
Preetha M, Chung AY, Lim-Tan SK, et al. Intrahepatic biliary cystadenoma presenting with obstructive jaundice. Asian J Surg. 2004;27:243–5.
Ohtsubo K, Ohta H, Sakai J, et al. Mucin-producing biliary papillomatosis associated with gastrobiliary fistula. J Gastroenterol. 1999;34:141–4.
Thomas JA, Scriven MW, Puntis MC, et al. Elevated serum CA 19-9 levels in hepatobiliary cystadenoma with mesenchymal stroma. Two case reports with immunohistochemical confirmation. Cancer. 1992;70:1841–6.
Delis SG, Touloumis Z, Bakoyiannis A, et al. Intrahepatic biliary cystadenoma: a need for radical resection. Eur J Gastroenterol Hepatol. 2008;20:10–4.
Schoonbroodt D, Horsmans Y, Gigot JF, et al. Biliary cystadenoma of the liver with elevated CA19-9. Liver. 1994;14:320–2.
Thomas KT, Welch D, Trueblood A, et al. Effective treatment of biliary cystadenoma. Ann Surg. 2005;241:769–75.
Horsmans Y, Laka A, Gigot JF, et al. Serum and cystic fluid CA 19-9 determinations as a diagnostic help in liver cysts of uncertain nature. Liver. 1996;16:255–7.
Koffron A, Ferrario M, Rao S, et al. Intrahepatic biliary cystadenoma (IBC): role of cyst fluid analysis and surgical management in the laparoscopic era. Surgery. 2004;136:926–36.
Choi HK, Lee JK, Lee KH, et al. Differential diagnosis for intrahepatic biliary cystadenoma and hepatic simple cyst significance of cystic fluid analysis and radiologic findings. J Clin Gastroenterol. 2010;44:289–93.
Choi BI, Lim JH, Han MC, et al. Biliary cystadenoma and cystadenocarcinoma: CT and sonographic findings. Radiology. 1989;171:57–61.
Buetow PC, Buck JL, Pantongrag-Brown L, et al. Biliary cystadenoma and cystadenocarcinoma: clinical-imaging-pathologic correlation with emphasis on the importance of ovarian stroma. Radiology. 1995;196:805–10.
Regev A, Reddy KR, Berho M, et al. Large cystic lesions of the liver in adults: 15-year experience in a tertiary center. J Am Coll Surg. 2001;193:36–45.
Wang C, Miao R, Liu H, et al. Intrahepatic biliary cystadenoma and cystadenocarcinoma: an experience of 30 cases. Dig Liver Dis. 2012;44:426–31.
Limongelli P, Pai M, Damrah O, et al. Cystic tumors of the biliary tract: a complete excision is crucial. Int Surg. 2009;94:136–40.
Wu JM, Wu YM, Ho MC, et al. Surgical treatment of biliary cystadenomas. Int Surg. 2008;93:373–6.
Zhou J, Dong M, Kong F, et al. Giant mucinous biliary cystadenoma: a case report. Hepatobiliary Pancreat Dis Int. 2007;6:101–3.
Veroux M, Fiamingo P, Cillo U, et al. Cystadenoma and laparoscopic surgery for hepatic cystic disease: a need for laparotomy? Surg Endosc. 2005;19:1077–81.
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Wang, K., Kong, F., Dong, M. et al. Diagnosis and treatment of intrahepatic biliary cystadenoma: experience with 14 cases in a single center. Med Oncol 31, 274 (2014). https://doi.org/10.1007/s12032-014-0274-3
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DOI: https://doi.org/10.1007/s12032-014-0274-3