Biliary cystadenoma(BCA)is a rare hepatic neoplasm.Although considered a benign cystic tumor of the liver,BCA has a high risk of recurrence with incomplete excision and a potential risk for malignant degeneration.Corr...Biliary cystadenoma(BCA)is a rare hepatic neoplasm.Although considered a benign cystic tumor of the liver,BCA has a high risk of recurrence with incomplete excision and a potential risk for malignant degeneration.Correct diagnosis and complete tumor excision with negative margins are the mainstay of treatment.Unfortunately,due to the lack of presenting symptoms,and normal laboratory results in most patients,BCA is hard to distinguish from other cystic lesions of the liver such as biliary cystadenocarcinoma,hepatic cyst,hydatid cyst,Caroli disease,undifferentiated sarcoma,intraductal papillary mucinous tumor,and hepatocellular carcinoma.Ultrasound(US),computed tomography(CT)and magnetic resonance imaging(MRI)may be necessary.They demonstrate intrahepatic cystic lesions with features such as mural nodules,varying wall thickness,papillary projections,and internal septations.Nevertheless,surgery is still the only means of accurate diagnosis.Definitive diagnosis requires histological examination following formal resection.We describe a57-year-old woman initially diagnosed with polycystic liver who was subsequently diagnosed with giant intra-hepatic BCA in the left hepatic lobe.This indicates that both US physicians and hepatobiliary specialists should attach importance to hepatic cysts,and CT or MRI should be performed for further examination when a diagnosis of BCA is suspected.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 t展开更多
文摘Biliary cystadenoma(BCA)is a rare hepatic neoplasm.Although considered a benign cystic tumor of the liver,BCA has a high risk of recurrence with incomplete excision and a potential risk for malignant degeneration.Correct diagnosis and complete tumor excision with negative margins are the mainstay of treatment.Unfortunately,due to the lack of presenting symptoms,and normal laboratory results in most patients,BCA is hard to distinguish from other cystic lesions of the liver such as biliary cystadenocarcinoma,hepatic cyst,hydatid cyst,Caroli disease,undifferentiated sarcoma,intraductal papillary mucinous tumor,and hepatocellular carcinoma.Ultrasound(US),computed tomography(CT)and magnetic resonance imaging(MRI)may be necessary.They demonstrate intrahepatic cystic lesions with features such as mural nodules,varying wall thickness,papillary projections,and internal septations.Nevertheless,surgery is still the only means of accurate diagnosis.Definitive diagnosis requires histological examination following formal resection.We describe a57-year-old woman initially diagnosed with polycystic liver who was subsequently diagnosed with giant intra-hepatic BCA in the left hepatic lobe.This indicates that both US physicians and hepatobiliary specialists should attach importance to hepatic cysts,and CT or MRI should be performed for further examination when a diagnosis of BCA is suspected.
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 t
