Biliary Cystadenoma and Cystadenocarcinoma



Biliary Cystadenoma and Cystadenocarcinoma


Matthew M. Yeh, MD, PhD









The classic spindled and cellular ovarian-type stroma is seen underneath the cyst lining of a biliary cystadenoma.






This graphic shows a lobulated complex cystic mass with a vascularized wall, areas of solid growth, and well-defined septa typical of biliary cystadenocarcinoma.


TERMINOLOGY


Definitions



  • Cystic biliary neoplasm arising within liver



    • May arise in extrahepatic biliary tree, including gallbladder


ETIOLOGY/PATHOGENESIS


Unknown



  • May arise from gallbladder precursor elements or peribiliary glands


  • Most cystadenocarcinomas arise from preexisting biliary cystadenoma



    • Some may represent cystic variant of cholangiocarcinoma


    • Occasionally may arise in biliary cysts


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Rare; < 5% of cystic lesions of liver


  • Age



    • Average is 40-50 years


  • Gender



    • Biliary cystadenoma almost exclusively occurs in women


    • Biliary cystadenocarcinoma may be seen in men, given varied pathogenesis


Presentation



  • Pain, mass, and occasionally jaundice



    • Some patients are asymptomatic


Laboratory Tests



  • CA19-9 and CEA in cyst fluid helps differentiate between simple cyst and biliary cystic neoplasm


Treatment



  • Surgical approaches



    • Complete resection


Prognosis



  • Surgical resection should be curative



    • Incompletely resected tumor may recur or undergo malignant transformation


IMAGE FINDINGS


Ultrasonographic Findings

Only gold members can continue reading. Log In or Register to continue

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Biliary Cystadenoma and Cystadenocarcinoma
Premium Wordpress Themes by UFO Themes
%d bloggers like this: