Intrahepatic biliary cystadenoma mimicking hydatid cyst of liver: a clinicopathologic study of six cases

Zubair Ahmad,Nasir Uddin,Arsalan Ahmed,Wasim Memon,Jamshid Abdul-Ghafar

doi:10.1186/s13256-017-1481-2

Zubair Ahmad, Nasir Uddin + Show 3 more

Open Access

https://doi.org/10.1186/s13256-017-1481-2

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Abstract

BackgroundIntrahepatic biliary cystadenomas are rare hepatic neoplasms, which are usually cystic. These tumors are often misdiagnosed as simple liver cysts and hydatid cysts clinically and radiologically owing to nonspecific clinical and radiologic features. These tumors require complete resection, as recurrence and malignant transformation can occur following incomplete excision. It is essential that these tumors be diagnosed accurately so that they can be adequately excised.MethodsClinical and radiological features of six cases of biliary cystadenoma are described.ResultsAll of these cases were resected with the clinical and/or radiological impression of simple liver cysts and/or hydatid cysts. Out of the six patients, five were female and one was male. Ages of the patients ranged from 28 to 60 years (mean 45 years). The patients presented with nonspecific symptoms. Internal septations were seen on preoperative imaging (when available). On gross examination, all tumors were cystic; their sizes varied from 5.5 to 14 cm, mean size was 9.0 cm. On histopathologic examination, cystic spaces were lined by cuboidal to columnar mucin-secreting epithelium with underlying ovarian-type stroma. In one case, ovarian-type stroma was not seen. Recurrence was seen in three cases at 1 to 5 years of follow up.ConclusionsOwing to their malignant potential and high recurrence rate following incomplete resection, an aggressive surgical approach is recommended. Prognosis is excellent after complete resection.

Highlights

Intrahepatic biliary cystadenomas are rare hepatic neoplasms, which are usually cystic
Patients often present with nonspecific abdominal discomfort, some may present with more specific symptoms, such as jaundice [9, 10]. These tumors are often misdiagnosed as simple liver cysts clinically and even after exhaustive imaging studies such as ultrasound, computed tomography (CT) scan, and endoscopic retrograde cholangiopancreatography (ERCP) [5, 8, 9, 11]
We present six cases of biliary cystadenoma diagnosed in the Section of Histopathology, Aga Khan University Hospital (AKUH), Karachi, over a 7-year period from 2008 to 2015

Summary

Introduction

Intrahepatic biliary cystadenomas are rare hepatic neoplasms, which are usually cystic. These tumors are often misdiagnosed as simple liver cysts and hydatid cysts clinically and radiologically owing to nonspecific clinical and radiologic features. These tumors require complete resection, as recurrence and malignant transformation can occur following incomplete excision. Intrahepatic biliary cystadenomas are rare cysts forming hepatic neoplasms, which are usually multilocular. The cyst wall may be thickened, filled with thicker mucinous fluid and may show papillary projections. They range in size from 2.5 to 28.0 cm.

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