title: Hepatobiliary cystadenomas and cystadenocarcinomas: a report of 33 cases.
abstract: BACKGROUND
  Hepatobiliary cystadenomas and cystadenocarcinomas are rare and often misdiagnosed.
  
  
  OBJECTIVE
  We report our experience with 33 cases over 20 years to discuss an algorithm for these diseases.
  
  
  METHODS
  Patients presenting with a diagnosis of hepatobiliary cystadenomas and cystadenocarcinomas were retrospectively reviewed from January 1991 to October 2010. Clinical data were collected by examining hospital records and by follow-up questionnaire interviews.
  
  
  RESULTS
  Thirty-three patients had pathologically diagnosed hepatobiliary cystadenomas (19/33, 17 females and two males) or cystadenocarcinomas (14/33, five females and nine males). Symptoms of cystadenomas at hospitalization were abdominal bloating or pain (9/19). Nine patients had an elevated level of carbohydrate antigen (CA) 19-9. The surgical procedures, i.e. cyst enucleation, segmentectomy, sectionectomy and hemihepatectomy, were performed with satisfactory outcomes. Symptoms of cystadenocarcinomas included abdominal bloating or pain (8/14) and fever (3/14). Seven patients had elevated CA19-9. The imaging characteristics of cystadenocarcinomas were similar to those of cystadenomas. The clinical outcomes for cystadenocarcinomas were mostly poor after either surgical or conservative treatment.
  
  
  CONCLUSIONS
  Clinical symptoms are unreliable for these diagnoses and their differential diagnosis. Imaging evaluations and CA19-9 are of value for the recognition of cystadenoma and cystadenocarcinoma, but not for their differential diagnosis. Any recurrence of liver cyst after surgery or other treatments should lead one to suspect one of these diseases. Invasive examination and percutaneous fine-needle aspiration cytology are not recommended. Complete excision or careful enucleation should be the first treatment choice for a better prognosis.
authors: Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing, China
authors: Xinting
authors: X
authors: Sang
authors: Yongliang
authors: Y
authors: Sun
authors: Yilei
authors: Y
authors: Mao
authors: Zhiying
authors: Z
authors: Yang
authors: Xin
authors: X
authors: Lu
authors: Huayu
authors: H
authors: Yang
authors: Haifeng
authors: H
authors: Xu
authors: Shouxian
authors: S
authors: Zhong
authors: Jiefu
authors: J
authors: Huang
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D001662:Biliary Tract Surgical Procedures; D018395:CA-19-9 Antigen / Q000097:blood; D002681:China; D003536:Cystadenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D003537:Cystadenoma / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005334:Fever / Q000209:etiology; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D018395:CA-19-9 Antigen