Hepatobiliary Cystadenoma: a Report of Two Cases
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Fu-Chun Yu1, Jui-Hao Chen1, Kuo- Ching Yang1, Chin-Chu Wu2,
Yuh-Yu Chou3
1) Department of Gastroenterology,
2) Department of Radiology,
3) Department of Pathology, Shin Kong Wu Ho-Su Memorial Hospital,
Taipei, Taiwan
Abstract
We report two cases of hepatobiliary cystadenoma. Case 1. A 58-year-old
male presented with dull abdominal pain and recurrent jaundice.
Abdominal echo revealed biliary tracts dilatation; ERCP revealed
amorphous filling defect inside the dilated CBD, a cystic tumor
in the left lobe communicated with bile duct was disclosed by
MRI/MRCP. He received left lobectomy and microscopic findings
proved hepatobiliary cystadenoma. Case 2. Abdominal ultrasound
detected a huge cystic tumor over the left hepatic lobe in a 69-year-old
male. Abdominal CT revealed a large cystic mass lesion over the
left hepatic lobe with septations and multiple papillary projections.
A liver biopsy was performed and microscopic findings proved biliary
cystadenoma. An abdominal ultrasound 6 months later revealed intrahepatic
spread of cystadenocarcinoma over both lobes. Hepatobiliary cystadenoma
is a rare benign cystic tumor of the liver. It usually occurs
in middle-aged women and can undergo malignant change and become
lethal. It is frequently misdiagnosed and should be suspected
when a uni- or multilocular cystic lesion with papillary infoldings
is detected in the liver by CT or ultrasound. ERCP/MRCP have a
role in pre-operative evaluation. Elevated serum and cystic fluid
tumor markers CA19-9 are only seen in some patients; cystic fluid
cytology does not provide adequate diagnostic aid. Its morphologic
features maybe confused with biliary papillomatosis or IPMN of
bile duct. Its prognosis is excellent after complete resection.
Key words
Hepatobiliarycysta denoma - hepatobiliary cystadenocarcinoma -
hepatic cystic tumor - IPMN - biliary papillomatosis - obstructive
jaundice
