Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver,which is often misdiagnosed due to a poor recognition of it.We report a case of a 60-year-old man with biliary cystadenocarcinoma with his ...Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver,which is often misdiagnosed due to a poor recognition of it.We report a case of a 60-year-old man with biliary cystadenocarcinoma with his real time contrast enhanced ultrasound(CEUS)characteristics compared to those of computed tomography(CT)and magnetic resonance imaging(MRI),which were correlated with the surgical and pathologic findings.Cystic wall enhancement,internal septations and intra-cystic solid portions in the arterial phase were observed on CEUS after contrast agent injection.The enhancement was washed out progressively and depicted as hypo-enhancement in the portal and late phases.CT revealed a large irregular cystic lesion in the left liver lobe with no clear septations and solid components.MRI showed an irregular cystic occupying lesion with septations.展开更多
AIM: To investigate preoperative differential diagnoses made between intrahepatic biliary cystadenoma and intrahepatic biliary cystadenocarcinoma. METHODS: A retrospective analysis of patient data was performed, which...AIM: To investigate preoperative differential diagnoses made between intrahepatic biliary cystadenoma and intrahepatic biliary cystadenocarcinoma. METHODS: A retrospective analysis of patient data was performed, which included 21 cases of intrahepatic biliary cystadenoma and 25 cases of intrahepatic biliary cystadenocarcinoma diagnosed between April 2003 and April 2013 at the General Hospital of PLA. Potential patients were excluded whose diagnoses were not confirmed pathologically. Basic information (including patient age and gender), clinical manifestation, duration of symptoms, serum assay results (including tumor markers and the results of liver function tests), radiological features and pathological results were collected. All patients were followed up. RESULTS: Preoperative levels of cancer antigen 125 (12.51 +/- 9.31 vs 23.20 +/- 21.86, P < 0.05) and carbohydrate antigen 19-9 (22.56 +/- 26.30 vs 72.55 +/- 115.99, P < 0.05) were higher in the cystadenocarcinoma subgroup than in the cystadenoma subgroup. There were no statistically significant differences in age or gender between the two groups, or in pre- or post-operative levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin (TBIL), and direct bilirubin (DBIL) between the two groups. However, eight of the 21 patients with cystadenoma and six of the 25 patients with cystadenocarcinoma had elevated levels of TBIL and DBIL. There were three cases in the cystadenoma subgroup and six cases in the cystadenocarcinoma subgroup with postoperative complications. CONCLUSION: Preoperative differential diagnosis relies on the integration of information, including clinical symptoms, laboratory findings and imaging results. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.展开更多
Background：Surgical resection is generally considered the main curative treatment for intrahepatic biliary cystadenocarcinoma （IBCA） or suspected IBCAs,but controversy exists regarding the prognosis for IBCAs.This ...Background：Surgical resection is generally considered the main curative treatment for intrahepatic biliary cystadenocarcinoma （IBCA） or suspected IBCAs,but controversy exists regarding the prognosis for IBCAs.This study aimed to describe the clinicopathological characteristics of IBCA and identify prognostic factors that may influence the survival of patients treated with surgical procedures.Methods：Thirty-four patients with histologically confirmed IBCA treated between January 2000 and June 2014 were included.The clinical characteristics of patients with IBCA were compared with those of 41 patients with intrahepatic biliary cystadenoma （IBC）;factors that significant difference were analyzed for prognosis analysis of IBCA using multivariate/univariate Cox proportional hazards regression models.Survival curves were constructed using the Kaplan-Meier method and compared using the log-rank test.Results：IBCAs had a strong female predominance,and the most common presenting symptoms were abdominal pain or discomfort.Compared with IBCs,IBCAs occurred in older patients,in more male patients,and were associated statistically significant abnormal increase in alanine aminotransferase （P =0.01） and total bilirubin （P =0.04）.Mural nodules were more frequently seen with IBCAs and may associate with malignancy.It was difficult to differentiate between IBC and IBCA based on laboratory examination and imaging findings.Although complete resection is recommended,enucleation with negative margins also achieved good outcomes.Median overall patient survival was 76.2 months;survival at 1,3,and 5 years was 88.0％,68.7％,and 45.8％,respectively.Radical resection and noninvasive tumor type were independent prognostic factors for overall survival.Conclusions：It remains difficult to distinguish between cystadenomas and cystadenocarcinomas based on laboratory examination and image findings.Complete resection is recommended for curative treatment,and patients should be closely followed postoperatively,particularly those with invasive tumors.展开更多
Biliary cystadenomas are rare, cystic neoplasms of the biliary ductal system that usually occur in middle- aged women. They cannot be safely differentiated from cystadenocarcinomas before operation and should always b...Biliary cystadenomas are rare, cystic neoplasms of the biliary ductal system that usually occur in middle- aged women. They cannot be safely differentiated from cystadenocarcinomas before operation and should always be considered for resection. Cystadenomas have a strong tendency to recur, particularly following incomplete excision, and a potential of malignant transformation. Therefore, complete resection is the therapy of choice and thorough histopathologic evaluation is imperative. A case of benign biliary cystadenoma with mesenchymal stroma is presented along with a review of the relative literature addressing the clinical presentation, histology, histogenesis, differential diagnosis, imaging features, treatment and prognosis of this interesting and rare entity.展开更多
Biliary mucinous cystadenomas are cystic neoplasms commonly mistaken for simple cysts.They are rare and generally benign tumors,often incidentally found on imaging and during unrelated surgical interventions.They tend...Biliary mucinous cystadenomas are cystic neoplasms commonly mistaken for simple cysts.They are rare and generally benign tumors,often incidentally found on imaging and during unrelated surgical interventions.They tend to be slow growing though may reach symptomatic dimensions.Misdiagnosis of biliary mucinous cystadenomas may have serious consequences secondary to their potential for malignant transformation into biliary mucinous cystadenocarcinomas.Here,we review the epidemiology,etiology,pathology,diagnostic modalities,histology,and available treatment methods for mucinous cystadenomas reported in current literature.展开更多
文摘Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver,which is often misdiagnosed due to a poor recognition of it.We report a case of a 60-year-old man with biliary cystadenocarcinoma with his real time contrast enhanced ultrasound(CEUS)characteristics compared to those of computed tomography(CT)and magnetic resonance imaging(MRI),which were correlated with the surgical and pathologic findings.Cystic wall enhancement,internal septations and intra-cystic solid portions in the arterial phase were observed on CEUS after contrast agent injection.The enhancement was washed out progressively and depicted as hypo-enhancement in the portal and late phases.CT revealed a large irregular cystic lesion in the left liver lobe with no clear septations and solid components.MRI showed an irregular cystic occupying lesion with septations.
文摘AIM: To investigate preoperative differential diagnoses made between intrahepatic biliary cystadenoma and intrahepatic biliary cystadenocarcinoma. METHODS: A retrospective analysis of patient data was performed, which included 21 cases of intrahepatic biliary cystadenoma and 25 cases of intrahepatic biliary cystadenocarcinoma diagnosed between April 2003 and April 2013 at the General Hospital of PLA. Potential patients were excluded whose diagnoses were not confirmed pathologically. Basic information (including patient age and gender), clinical manifestation, duration of symptoms, serum assay results (including tumor markers and the results of liver function tests), radiological features and pathological results were collected. All patients were followed up. RESULTS: Preoperative levels of cancer antigen 125 (12.51 +/- 9.31 vs 23.20 +/- 21.86, P < 0.05) and carbohydrate antigen 19-9 (22.56 +/- 26.30 vs 72.55 +/- 115.99, P < 0.05) were higher in the cystadenocarcinoma subgroup than in the cystadenoma subgroup. There were no statistically significant differences in age or gender between the two groups, or in pre- or post-operative levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin (TBIL), and direct bilirubin (DBIL) between the two groups. However, eight of the 21 patients with cystadenoma and six of the 25 patients with cystadenocarcinoma had elevated levels of TBIL and DBIL. There were three cases in the cystadenoma subgroup and six cases in the cystadenocarcinoma subgroup with postoperative complications. CONCLUSION: Preoperative differential diagnosis relies on the integration of information, including clinical symptoms, laboratory findings and imaging results. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
文摘Background：Surgical resection is generally considered the main curative treatment for intrahepatic biliary cystadenocarcinoma （IBCA） or suspected IBCAs,but controversy exists regarding the prognosis for IBCAs.This study aimed to describe the clinicopathological characteristics of IBCA and identify prognostic factors that may influence the survival of patients treated with surgical procedures.Methods：Thirty-four patients with histologically confirmed IBCA treated between January 2000 and June 2014 were included.The clinical characteristics of patients with IBCA were compared with those of 41 patients with intrahepatic biliary cystadenoma （IBC）;factors that significant difference were analyzed for prognosis analysis of IBCA using multivariate/univariate Cox proportional hazards regression models.Survival curves were constructed using the Kaplan-Meier method and compared using the log-rank test.Results：IBCAs had a strong female predominance,and the most common presenting symptoms were abdominal pain or discomfort.Compared with IBCs,IBCAs occurred in older patients,in more male patients,and were associated statistically significant abnormal increase in alanine aminotransferase （P =0.01） and total bilirubin （P =0.04）.Mural nodules were more frequently seen with IBCAs and may associate with malignancy.It was difficult to differentiate between IBC and IBCA based on laboratory examination and imaging findings.Although complete resection is recommended,enucleation with negative margins also achieved good outcomes.Median overall patient survival was 76.2 months;survival at 1,3,and 5 years was 88.0％,68.7％,and 45.8％,respectively.Radical resection and noninvasive tumor type were independent prognostic factors for overall survival.Conclusions：It remains difficult to distinguish between cystadenomas and cystadenocarcinomas based on laboratory examination and image findings.Complete resection is recommended for curative treatment,and patients should be closely followed postoperatively,particularly those with invasive tumors.
文摘Biliary cystadenomas are rare, cystic neoplasms of the biliary ductal system that usually occur in middle- aged women. They cannot be safely differentiated from cystadenocarcinomas before operation and should always be considered for resection. Cystadenomas have a strong tendency to recur, particularly following incomplete excision, and a potential of malignant transformation. Therefore, complete resection is the therapy of choice and thorough histopathologic evaluation is imperative. A case of benign biliary cystadenoma with mesenchymal stroma is presented along with a review of the relative literature addressing the clinical presentation, histology, histogenesis, differential diagnosis, imaging features, treatment and prognosis of this interesting and rare entity.
文摘Biliary mucinous cystadenomas are cystic neoplasms commonly mistaken for simple cysts.They are rare and generally benign tumors,often incidentally found on imaging and during unrelated surgical interventions.They tend to be slow growing though may reach symptomatic dimensions.Misdiagnosis of biliary mucinous cystadenomas may have serious consequences secondary to their potential for malignant transformation into biliary mucinous cystadenocarcinomas.Here,we review the epidemiology,etiology,pathology,diagnostic modalities,histology,and available treatment methods for mucinous cystadenomas reported in current literature.
