- Hepatobiliary Cystadenomas and Cystadenocarcinomas: Report of 33 Cases
- 作者:孙永亮|发布时间:2011-07-05|浏览量:538次
Background Hepatobiliary cystadenomas and cystadenocarcinomas are rare and often misdiagnosed.
Aims 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 follow-up questionnaire interview.北京中日友好医院肝胆外科孙永亮
Results Thirty-three patients had pathologically diagnosed hepatobiliary cystadenomas (19/33, 17 females and 2 males) or cystadenocarcinomas (14/33, 5 females and 9 males). Symptoms of cystadenomas at hospitalization were abdominal bloating or pain (9/19). Nine patients had elevated level of carbohydrate antigen 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 were with 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 the differential diagnosis of them. 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.
文章发表于Liver International