Biliary cystadenomas: a case for complete resection

Abstract

Introduction and Objective. Biliary cystadenoma is a rare benign neoplasm of the liver with less than 200 cases being reported allover the world. We report a series of 13 cases highlighting the radiological findings and problems related to its management. Materials and Methods. Records of thirteen patients who underwent surgery for biliary cystadenomas, between March 2006 and October 2011, were reviewed retrospectively. Results. Majority of the patients were females (11 out of 13), with a median age of 46 (23-65) years. The most frequent symptom was abdominal pain (92%). Seven patients had presented with history of previous surgery for liver lesions. Five patients had presented with recurrence after partial resection for a suspected hydatid cyst and two after surgery for presumed simple liver cyst. Ten of the 13 patients had complete resection of the cyst with enucleation in 3 patients, 2 of whom in addition required T-tube drainage of the bile duct. There has been no recurrence during the follow-up period ranging from 3 months to 5 years. Conclusion. Biliary cystadenoma must be differentiated from other benign cysts. Hepatic resection or cyst enucleation is the recommended treatment option.

Figure 1

Contrast-enhanced CT scan showing large cystic lesion in liver with multiple-enhancing septae.

Figure 2

Peroperative picture showing large thick-walled cystic lesion arising from left lobe of liver.

Figure 3

Remnant right lobe of liver after left hepatectomy.

Figure 4

T1-weighted MRI image showing large multiseptated cystic lesion in right lobe of liver.

Figure 5

Enucleated specimen of biliary cystadenoma.

Figure 6

10× histology picture showing dilated bile duct with low columnar epithelium and spindle-shaped cells in stroma (ovarian like stroma).