title: Surgical management of biliary cystadenoma and cystadenocarcinoma of the liver.
abstract: Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) are rare biliary duct neoplasms. This study investigated reasonable management strategies of cystic neoplasms in the liver. Charts of 39 BCA/BCAC patients (9 males, 30 female; median age 53.74 ± 14.50 years) who underwent surgery from January 1999 to December 2009 were reviewed retrospectively. Cyst fluid samples of 32 BCA/BCAC patients and 40 simple hepatic cyst patients were examined for the tumor markers carbohydrate associated antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). The most frequent symptoms were abdominal pain (N = 10), abdominal mass (N = 7), abdominal distension (N = 4), jaundice (N = 2), and fever (N = 3); the remaining patients showed no clinical symptoms. Liver resection (N = 17) or enucleation (N = 22) was performed in the 39 patients. Ultimately, 35 patients were diagnosed with intrahepatic BCA and four patients were diagnosed with BCAC. The median CA19-9 level was significantly higher in BCA/BCAC patients than in simple hepatic cyst patients. The median CEA levels in BCA/BCAC patients and controls were 6.83 ± 2.43 and 4.21 ± 2.91 mg/L, respectively. All symptoms were resolved after surgery, and only one BCAC patient showed recurrence. The incidence of intrahepatic cystic lesions was 1.7%. Increased CA19-9 levels in the cyst fluid is a helpful marker for distinguishing BCA/BCAC from common simple cysts. The presence of coarse calcifications is suggestive of BCAC. Complete surgical removal of these lesions yielded satisfying long-term outcomes with a very low recurrence rate.
authors.affiliation: Department of Hepatobiliary Surgery, Hepatobiliary Surgical Institute, Chinese PLA General Hospital, Beijing, China.
authors.forename: Y W
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Department of Hepatobiliary Surgery, Hepatobiliary Surgical Institute, Chinese PLA General Hospital, Beijing, China.
authors.forename: C H
authors.initials: CH
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery, Hepatobiliary Surgical Institute, Chinese PLA General Hospital, Beijing, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary Surgery, Hepatobiliary Surgical Institute, Chinese PLA General Hospital, Beijing, China.
authors.forename: J H
authors.initials: JH
authors.lastname: Dong
authors.affiliation: Department of Hepatobiliary Surgery, Hepatobiliary Surgical Institute, Chinese PLA General Hospital, Beijing, China.
authors.forename: W Z
authors.initials: WZ
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, Hepatobiliary Surgical Institute, Chinese PLA General Hospital, Beijing, China JiangK301@126.com.
authors.forename: K
authors.initials: K
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000235:genetics; D001652:Bile Ducts / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001661:Biliary Tract Neoplasms / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014408:Biomarkers, Tumor / Q000235:genetics*; D002272:Carcinoembryonic Antigen / Q000235:genetics; D003536:Cystadenocarcinoma / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D003537:Cystadenoma / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D015870:Gene Expression; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; C578959:carbohydrate antigen 199, human