Skip to main content
SpringerLink
Log in

Adenoma and Biliary Cystadenoma

  • Chapter
Benign Tumors of the Liver

  • 1725 Accesses

Abstract

Hepatic adenomas are rare liver tumors whose pathomolecular classification distinguishes it from other hepatic lesions and directly impacts its clinical course. The incidence of hepatic adenomas is about 0.1 per 100,000 in non-oral contraceptive users versus 4 per 100,000 in oral contraceptive users. Biliary cystadenomas are rare epithelial tumors which account for less than 5 % of all cystic liver lesions. Although benign, both hepatic adenomas and biliary cystadenomas have malignant potential and can progress to hepatocellular carcinoma and biliary cystadenocarcinoma, respectively. More liberal use of cross-sectional imaging has led to increased diagnosis of both neoplasms. A careful and thorough diagnostic evaluation is necessary. Appropriate management consists of complete surgical excision and obtaining negative margins in order to lower the likelihood of recurrent or residual neoplastic disease. We describe the incidence, etiology, clinical presentation, and therapy of both lesions with a particular emphasis on appropriate management of these rare liver neoplasms.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Reddy KR et al (2001) Benign and solid tumors of the liver: relationship to sex, age, size of tumors, and outcome. Am Surg 67(2):173–178

    CAS  PubMed  Google Scholar 

  2. Balabaud C et al (2013) Focal nodular hyperplasia and hepatocellular adenoma around the world viewed through the scope of the immunopathological classification. Int J Hepatol 2013:268625. doi:10.1155/2013/268625

    Article  PubMed Central  PubMed  Google Scholar 

  3. Guy J, Peters MG (2013) Liver disease in women: the influence of gender on epidemiology, natural history, and patient outcomes. Gastroenterol Hepatol 9(10):633–639

    Google Scholar 

  4. Barthelmes L, Tait IS (2005) Liver cell adenoma and liver cell adenomatosis. HPB (Oxford) 7(3):186–196. doi:10.1080/13651820510028954

    Article  Google Scholar 

  5. Reznik Y et al (2004) Hepatocyte nuclear factor-1 alpha gene inactivation: cosegregation between liver adenomatosis and diabetes phenotypes in two maturity-onset diabetes of the young (MODY)3 families. J Clin Endocrinol Metab 89(3):1476–1480. doi:10.1210/jc.2003-031552

    Article  CAS  PubMed  Google Scholar 

  6. Labrune P et al (1997) Hepatocellular adenomas in glycogen storage disease type I and III: a series of 43 patients and review of the literature. J Pediatr Gastroenterol Nutr 24(3):276–279

    Article  CAS  PubMed  Google Scholar 

  7. Chang CY et al (2013) Changing epidemiology of hepatocellular adenoma in the United States: review of the literature. Int J Hepatol 2013:604860. doi:10.1155/2013/604860

    Article  PubMed Central  PubMed  Google Scholar 

  8. Bioulac-Sage P et al (2012) Hepatocellular adenoma subtypes: the impact of overweight and obesity. Liver Int 32(8):1217–1221. doi:10.1111/j.1478-3231.2012.02786.x

    Article  PubMed  Google Scholar 

  9. Paradis V (2013) Hepatocellular adenomas: WHO classification and immunohistochemical workup. Surg Pathol Clin 6(2):311–331

    Article  Google Scholar 

  10. Farges O et al (2011) Changing trends in malignant transformation of hepatocellular adenoma. Gut 60(1):85–89. doi:10.1136/gut.2010.222109

    Article  PubMed  Google Scholar 

  11. Zucman-Rossi J et al (2006) Genotype-phenotype correlation in hepatocellular adenoma: new classification and relationship with HCC. Hepatology 43(3):515–524. doi:10.1002/hep.21068

    Article  CAS  PubMed  Google Scholar 

  12. Evason KJ et al (2013) Atypical hepatocellular adenoma-like neoplasms with beta-catenin activation show cytogenetic alterations similar to well-differentiated hepatocellular carcinomas. Hum Pathol 44(5):750–758. doi:10.1016/j.humpath.2012.07.019

    Article  CAS  PubMed  Google Scholar 

  13. Bioulac-Sage P et al (2007) Hepatocellular adenoma subtype classification using molecular markers and immunohistochemistry. Hepatology 46(3):740–748. doi:10.1002/hep.21743

    Article  CAS  PubMed  Google Scholar 

  14. Shafizadeh N et al (2014) Hepatocellular adenomas in a large community population, 2000 to 2010: reclassification per current World Health Organization classification and results of long-term follow-up. Hum Pathol 45(5):976–983. doi:10.1016/j.humpath.2013.12.011

    Article  PubMed  Google Scholar 

  15. Bluteau O et al (2002) Bi-allelic inactivation of TCF1 in hepatic adenomas. Nat Genet 32(2):312–315. doi:10.1038/ng1001

    Article  CAS  PubMed  Google Scholar 

  16. Bacq Y et al (2003) Familial liver adenomatosis associated with hepatocyte nuclear factor 1alpha inactivation. Gastroenterology 125(5):1470–1475

    Article  PubMed  Google Scholar 

  17. Bioulac-Sage P et al (2011) Pathological diagnosis of hepatocellular adenoma in clinical practice. Diagn Histopathol 17(12):521–529

    Article  Google Scholar 

  18. Rebouissou S et al (2009) Frequent in-frame somatic deletions activate gp130 in inflammatory hepatocellular tumours. Nature 457(7226):200–204. doi:10.1038/nature07475

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Paradis V et al (2007) Telangiectatic adenoma: an entity associated with increased body mass index and inflammation. Hepatology 46(1):140–146. doi:10.1002/hep.21684

    Article  PubMed  Google Scholar 

  20. Katabathina VS et al (2011) Genetics and imaging of hepatocellular adenomas: 2011 update. Radiographics 31(6):1529–1543. doi:10.1148/rg.316115527

    Article  PubMed  Google Scholar 

  21. Bioulac-Sage P et al (2010) Subtype classification of hepatocellular adenoma. Dig Surg 27(1):39–45. doi:10.1159/000268406

    Article  CAS  PubMed  Google Scholar 

  22. Dokmak S et al (2009) A single-center surgical experience of 122 patients with single and multiple hepatocellular adenomas. Gastroenterology 137(5):1698–1705. doi:10.1053/j.gastro.2009.07.061

    Article  PubMed  Google Scholar 

  23. van Aalten SM et al (2012) Systematic review of haemorrhage and rupture of hepatocellular adenomas. Br J Surg 99(7):911–916. doi:10.1002/bjs.8762

    Article  PubMed  Google Scholar 

  24. Farges O, Dokmak S (2010) Malignant transformation of liver adenoma: an analysis of the literature. Dig Surg 27(1):32–38. doi:10.1159/000268405

    Article  PubMed  Google Scholar 

  25. Bioulac-Sage P et al (2009) Hepatocellular adenoma management and phenotypic classification: the Bordeaux experience. Hepatology 50(2):481–489. doi:10.1002/hep.22995

    Article  PubMed  Google Scholar 

  26. Takigawa Y, Brown AM (2008) Wnt signaling in liver cancer. Curr Drug Targets 9(11):1013–1024

    Article  CAS  PubMed  Google Scholar 

  27. van der Windt DJ et al (2006) Case-orientated approach to the management of hepatocellular adenoma. Br J Surg 93(12):1495–1502. doi:10.1002/bjs.5511

    Article  PubMed  Google Scholar 

  28. Stoot JH et al (2007) Life-saving therapy for haemorrhaging liver adenomas using selective arterial embolization. Br J Surg 94(10):1249–1253. doi:10.1002/bjs.5779

    Article  CAS  PubMed  Google Scholar 

  29. Walt AJ (1977) Cysts and benign tumors of the liver. Surg Clin North Am 57(2):449–464

    CAS  PubMed  Google Scholar 

  30. Arnaoutakis DJ et al (2014) Management of biliary cystic tumors: a multi-institutional analysis of a rare liver tumor. Ann Surg. doi:10.1097/SLA.0000000000000543

    Google Scholar 

  31. Sang X et al (2011) Hepatobiliary cystadenomas and cystadenocarcinomas: a report of 33 cases. Liver Int 31(9):1337–1344. doi:10.1111/j.1478-3231.2011.02560.x

    Article  PubMed  Google Scholar 

  32. Devaney K et al (1994) Hepatobiliary cystadenoma and cystadenocarcinoma. A light microscopic and immunohistochemical study of 70 patients. Am J Surg Pathol 18(11):1078–1091

    Article  CAS  PubMed  Google Scholar 

  33. Dixon E et al (2001) Cystadenoma of the liver without mesenchymal stroma in a female following hormonal therapy for acne. HPB (Oxford) 3(2):183–186. doi:10.1080/136518201317077224

    Article  CAS  Google Scholar 

  34. Seo JK et al (2010) Appropriate diagnosis of biliary cystic tumors: comparison with atypical hepatic simple cysts. Eur J Gastroenterol Hepatol 22(8):989–996. doi:10.1097/MEG.0b013e328337c971

    Article  PubMed  Google Scholar 

  35. Vogt DP et al (2005) Cystadenoma and cystadenocarcinoma of the liver: a single center experience. J Am Coll Surg 200(5):727–733. doi:10.1016/j.jamcollsurg.2005.01.005

    Article  PubMed  Google Scholar 

  36. Soares KC et al (2014) Cystic neoplasms of the liver: biliary cystadenoma and cystadenocarcinoma. J Am Coll Surg 218(1):119–128. doi:10.1016/j.jamcollsurg.2013.08.014

    Article  PubMed Central  PubMed  Google Scholar 

  37. Emre A et al (2011) Intrahepatic biliary cystic neoplasms: surgical results of 9 patients and literature review. World J Gastroenterol 17(3):361–365. doi:10.3748/wjg.v17.i3.361

    Article  PubMed Central  PubMed  Google Scholar 

  38. Wheeler DA, Edmondson HA (1985) Cystadenoma with mesenchymal stroma (CMS) in the liver and bile ducts. A clinicopathologic study of 17 cases, 4 with malignant change. Cancer 56(6):1434–1445

    Article  CAS  PubMed  Google Scholar 

  39. Edmondson HA, Atlas of tumor pathology (1958) Tumors of the liver and intrahepatic bile ducts. Armed Forces Institute of Pathology, Washington, DC

    Google Scholar 

  40. Hai S et al (2003) Surgical management of cystic hepatic neoplasms. J Gastroenterol 38(8):759–764. doi:10.1007/s00535-003-1142-7

    Article  PubMed  Google Scholar 

  41. Garcea G et al (2013) Surgical management of cystic lesions in the liver. ANZ J Surg 83(7–8):E3–E20. doi:10.1111/j.1445-2197.2012.06096.x

    Article  PubMed  Google Scholar 

  42. Grisolia A et al (2009) A simple sonographic scoring system combined with routine serology is useful in differentiating parasitic from non-parasitic cysts of the liver(). J Ultrasound 12(2):75–79. doi:10.1016/j.jus.2009.02.004

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  43. Lauffer JM et al (1998) Biliary cystadenocarcinoma of the liver: the need for complete resection. Eur J Cancer 34(12):1845–1851

    Article  CAS  PubMed  Google Scholar 

  44. Zen Y et al (2006) Biliary cystic tumors with bile duct communication: a cystic variant of intraductal papillary neoplasm of the bile duct. Mod Pathol 19(9):1243–1254. doi:10.1038/modpathol.3800643

    Article  PubMed  Google Scholar 

  45. Tomioka T et al (1986) Cystadenoma and cystadenocarcinoma of the liver: localization of carcinoembryonic antigen. Jpn J Surg 16(1):62–67

    Article  CAS  PubMed  Google Scholar 

  46. Ishibashi Y et al (2007) Invasive biliary cystic tumor without ovarian-like stroma. Pathol Int 57(12):794–798. doi:10.1111/j.1440-1827.2007.02176.x

    Article  PubMed  Google Scholar 

  47. Koffron A et al (2004) Intrahepatic biliary cystadenoma: role of cyst fluid analysis and surgical management in the laparoscopic era. Surgery 136(4):926–936. doi:10.1016/j.surg.2004.06.031

    Article  PubMed  Google Scholar 

  48. Manouras A et al (2008) Laparoscopic fenestration of multiple giant biliary mucinous cystadenomas of the liver. World J Gastroenterol 14(26):4257–4259

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, The Johns Hopkins School of Medicine, Blalock 688, 600 N. Wolfe Street, Baltimore, MD, 21287, USA

    Kevin C. Soares, Andrew J. Page & Timothy M. Pawlik MD MPH, PhD

  2. Department of Radiology, The Johns Hopkins School of Medicine, Baltimore, MD, USA

    Ihab Kamel

Authors
  1. Kevin C. Soares
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew J. Page
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ihab Kamel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Timothy M. Pawlik MD MPH, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Timothy M. Pawlik MD MPH, PhD .

Editor information

Editors and Affiliations

  1. Hepatobiliary Surgery, San Raffaele Hospital, Milano, Milano, Italy

    Luca Aldrighetti

  2. IRCCS MultiMedica Hospital, Sesto San Giovanni, Milano, Italy

    Francesco Cetta

  3. Hepatobiliary Surgery, San Raffaele Hospital, Milano, Italy

    Gianfranco Ferla

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing AG Switzerland

About this chapter

Cite this chapter

Soares, K.C., Page, A.J., Kamel, I., Pawlik, T.M. (2015). Adenoma and Biliary Cystadenoma. In: Aldrighetti, L., Cetta, F., Ferla, G. (eds) Benign Tumors of the Liver. Springer, Cham. https://doi.org/10.1007/978-3-319-12985-3_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-12985-3_14

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-12984-6

  • Online ISBN: 978-3-319-12985-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation