Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2006

Open Access 01-12-2006 | Case report

Emergency laparotomy for misdiagnosed biliary cystadenoma originating from caudate lobe

Published in: World Journal of Surgical Oncology | Issue 1/2006

Login to get access

Abstract

Background

Biliary cystadenoma is a rare benign neoplasm, which is often misdiagnosed for a hepatic abscess or a hydatid cyst that tends to recur and is at risk for progression to malignant neoplasm.

Case presentation

This case describes a 30-year-old woman admitted to our institution in an emergency setting. The patient was originally misdiagnosed as affected by a hepatic hydatid cyst at another hospital, and then emergently treated at our Institution for severe abdominal pain. Histologic evaluation of the cyst showed that it was a biliary cystadenoma and, therefore, the patient underwent a hepatic resection in order to completely remove the lesion.

Conclusion

Complete excision of any suspicious hepatic cystic lesion remains the best method for diagnosis and treatment of cystadenoma. Incomplete excision of most biliary cystadenoma results in a higher rate of recurrence and the risk of malignant transformation. We report this case to elucidate the clinical presentation, preoperative evaluation, and surgical treatment of these rare lesions.
Appendix
Available only for authorised users
Literature
1.
go back to reference Siren J, Karkkainen P, Luukkonen P, Kiviluoto T, Kivilaakso E: A case report of biliary cystadenoma and cystadenocarcinoma. Hepatogastroenterology. 1998, 45 (19): 83-89.PubMed Siren J, Karkkainen P, Luukkonen P, Kiviluoto T, Kivilaakso E: A case report of biliary cystadenoma and cystadenocarcinoma. Hepatogastroenterology. 1998, 45 (19): 83-89.PubMed
2.
go back to reference Thomas KT, Welch D, Trueblood A, Sulur P, Wise P, Gorden DL, Chari RS, Wright JK, Washington K, Pinson CW: Effective treatment of biliary cystadenoma. Ann Surg. 2005, 241 (5): 769-73; discussion 773-5. 10.1097/01.sla.0000161982.57360.1b.PubMedCentralCrossRefPubMed Thomas KT, Welch D, Trueblood A, Sulur P, Wise P, Gorden DL, Chari RS, Wright JK, Washington K, Pinson CW: Effective treatment of biliary cystadenoma. Ann Surg. 2005, 241 (5): 769-73; discussion 773-5. 10.1097/01.sla.0000161982.57360.1b.PubMedCentralCrossRefPubMed
3.
go back to reference Woods GL: Biliary cystadenocarcinoma: Case report of hepatic malignancy originating in benign cystadenoma. Cancer. 1981, 47 (12): 2936-2940. 10.1002/1097-0142(19810615)47:12<2936::AID-CNCR2820471234>3.0.CO;2-4.CrossRefPubMed Woods GL: Biliary cystadenocarcinoma: Case report of hepatic malignancy originating in benign cystadenoma. Cancer. 1981, 47 (12): 2936-2940. 10.1002/1097-0142(19810615)47:12<2936::AID-CNCR2820471234>3.0.CO;2-4.CrossRefPubMed
4.
go back to reference Chamberlain RS, Blumgart LH: Mucobilia in association with a biliary cystadenocarcinoma of the caudate duct: a rare cause of malignant biliary obstruction. HPB Surg. 2000, 11 (5): 345-351.PubMedCentralCrossRefPubMed Chamberlain RS, Blumgart LH: Mucobilia in association with a biliary cystadenocarcinoma of the caudate duct: a rare cause of malignant biliary obstruction. HPB Surg. 2000, 11 (5): 345-351.PubMedCentralCrossRefPubMed
5.
go back to reference Teoh AY, Ng SS, Lee KF, Lai PB: Biliary cystadenoma and other complicated cystic lesions of the liver: diagnostic and therapeutic challenges. World J Surg. 2006, 30 (8): 1560-1566. 10.1007/s00268-005-0461-7.CrossRefPubMed Teoh AY, Ng SS, Lee KF, Lai PB: Biliary cystadenoma and other complicated cystic lesions of the liver: diagnostic and therapeutic challenges. World J Surg. 2006, 30 (8): 1560-1566. 10.1007/s00268-005-0461-7.CrossRefPubMed
7.
go back to reference Lauffer JM, Baer HU, Maurer CA, Stoupis C, Zimmerman A, Buchler MW: Biliary cystadenocarcinoma of the liver: the need for complete resection. Eur J Cancer. 1998, 34 (12): 1845-1851. 10.1016/S0959-8049(98)00166-X.CrossRefPubMed Lauffer JM, Baer HU, Maurer CA, Stoupis C, Zimmerman A, Buchler MW: Biliary cystadenocarcinoma of the liver: the need for complete resection. Eur J Cancer. 1998, 34 (12): 1845-1851. 10.1016/S0959-8049(98)00166-X.CrossRefPubMed
8.
9.
go back to reference Devaney K, Goodman ZD, Ishak KG: Hepatobiliary cystadenoma and cystadenocarcinoma. A light microscopic and immunohistochemical study of 70 patients. Am J Surg Pathol. 1994, 18 (11): 1078-1091.CrossRefPubMed Devaney K, Goodman ZD, Ishak KG: Hepatobiliary cystadenoma and cystadenocarcinoma. A light microscopic and immunohistochemical study of 70 patients. Am J Surg Pathol. 1994, 18 (11): 1078-1091.CrossRefPubMed
10.
go back to reference Wheeler DA, Edmondson HA: Cystadenoma with mesenchymal stroma (CMS) in the liver and bile ducts. A clinicopathologic study of 17 cases, 4 with malignant change. Cancer. 1985, 56 (6): 1434-1445. 10.1002/1097-0142(19850915)56:6<1434::AID-CNCR2820560635>3.0.CO;2-F.CrossRefPubMed Wheeler DA, Edmondson HA: Cystadenoma with mesenchymal stroma (CMS) in the liver and bile ducts. A clinicopathologic study of 17 cases, 4 with malignant change. Cancer. 1985, 56 (6): 1434-1445. 10.1002/1097-0142(19850915)56:6<1434::AID-CNCR2820560635>3.0.CO;2-F.CrossRefPubMed
11.
go back to reference Blanchard, Samra S: A rare cause of cholestatic jaundice in teenager: biliary cystadenoma. Am J Gastroenterol. 2003, 98 (9): S141-10.1016/S0002-9270(03)01182-1.CrossRef Blanchard, Samra S: A rare cause of cholestatic jaundice in teenager: biliary cystadenoma. Am J Gastroenterol. 2003, 98 (9): S141-10.1016/S0002-9270(03)01182-1.CrossRef
12.
go back to reference Vogt DP, Henderson JM, Chmielewski E: Cystadenoma and cystadenocarcinoma of the liver: a single center experience. J Am Coll Surg. 2005, 200 (5): 727-733. 10.1016/j.jamcollsurg.2005.01.005.CrossRefPubMed Vogt DP, Henderson JM, Chmielewski E: Cystadenoma and cystadenocarcinoma of the liver: a single center experience. J Am Coll Surg. 2005, 200 (5): 727-733. 10.1016/j.jamcollsurg.2005.01.005.CrossRefPubMed
13.
go back to reference Palacios E, Shannon M, Solomon C, Guzman M: Biliary cystadenoma: ultrasound, CT, and MRI. Gastrointest Radiol. 1990, 15 (4): 313-316. 10.1007/BF01888807.CrossRefPubMed Palacios E, Shannon M, Solomon C, Guzman M: Biliary cystadenoma: ultrasound, CT, and MRI. Gastrointest Radiol. 1990, 15 (4): 313-316. 10.1007/BF01888807.CrossRefPubMed
14.
go back to reference Lewis WD, Jenkins RL, Rossi RL, Munson L, ReMine SG, Cady B, Braasch JW, McDermott WV: Surgical treatment of biliary cystadenoma. A report of 15 cases. Arch Surg. 1988, 123 (5): 563-568.CrossRefPubMed Lewis WD, Jenkins RL, Rossi RL, Munson L, ReMine SG, Cady B, Braasch JW, McDermott WV: Surgical treatment of biliary cystadenoma. A report of 15 cases. Arch Surg. 1988, 123 (5): 563-568.CrossRefPubMed
15.
go back to reference Madariaga JR, Iwatsuki S, Starzl TE, Todo S, Selby R, Zetti G: Hepatic resection for cystic lesions of the liver. Ann Surg. 1993, 218 (5): 610-614. 10.1097/00000658-199311000-00004.PubMedCentralCrossRefPubMed Madariaga JR, Iwatsuki S, Starzl TE, Todo S, Selby R, Zetti G: Hepatic resection for cystic lesions of the liver. Ann Surg. 1993, 218 (5): 610-614. 10.1097/00000658-199311000-00004.PubMedCentralCrossRefPubMed
16.
go back to reference Agildere AM, Haliloglu M, Akhan O: Biliary cystadenoma and cystadenocarcinoma. AJR Am J Roentgenol. 1991, 156 (5): 1113-CrossRefPubMed Agildere AM, Haliloglu M, Akhan O: Biliary cystadenoma and cystadenocarcinoma. AJR Am J Roentgenol. 1991, 156 (5): 1113-CrossRefPubMed
17.
go back to reference Ishak KG, Willis GW, Cummins SD, Bullock AA: Biliary cystadenoma and cystadenocarcinoma: report of 14 cases and review of the literature. Cancer. 1977, 39 (1): 322-338. 10.1002/1097-0142(197701)39:1<322::AID-CNCR2820390149>3.0.CO;2-P.CrossRefPubMed Ishak KG, Willis GW, Cummins SD, Bullock AA: Biliary cystadenoma and cystadenocarcinoma: report of 14 cases and review of the literature. Cancer. 1977, 39 (1): 322-338. 10.1002/1097-0142(197701)39:1<322::AID-CNCR2820390149>3.0.CO;2-P.CrossRefPubMed
18.
go back to reference Del Poggio P, Jamoletti C, Forloni B, De Benedictis R, Mattiello M, Corti D, Pezzica E: Malignant transformation of biliary cystadenoma: a difficult diagnosis. Dig Liver Dis. 2000, 32 (8): 733-736. 10.1016/S1590-8658(00)80339-4.CrossRefPubMed Del Poggio P, Jamoletti C, Forloni B, De Benedictis R, Mattiello M, Corti D, Pezzica E: Malignant transformation of biliary cystadenoma: a difficult diagnosis. Dig Liver Dis. 2000, 32 (8): 733-736. 10.1016/S1590-8658(00)80339-4.CrossRefPubMed
19.
go back to reference Kim K, Choi J, Park Y, Lee W, Kim B: Biliary cystadenoma of the liver. J Hepatobiliary Pancreat Surg. 1998, 5 (3): 348-352. 10.1007/s005340050058.CrossRefPubMed Kim K, Choi J, Park Y, Lee W, Kim B: Biliary cystadenoma of the liver. J Hepatobiliary Pancreat Surg. 1998, 5 (3): 348-352. 10.1007/s005340050058.CrossRefPubMed
20.
go back to reference Koffron A, Rao S, Ferrario M, Abecassis M: Intrahepatic biliary cystadenoma: role of cyst fluid analysis and surgical management in the laparoscopic era. Surgery. 2004, 136 (4): 926-936. 10.1016/j.surg.2004.06.031.CrossRefPubMed Koffron A, Rao S, Ferrario M, Abecassis M: Intrahepatic biliary cystadenoma: role of cyst fluid analysis and surgical management in the laparoscopic era. Surgery. 2004, 136 (4): 926-936. 10.1016/j.surg.2004.06.031.CrossRefPubMed
21.
go back to reference Lee JH, Chen DR, Pang SC, Lai YS: Mucinous biliary cystadenoma with mesenchymal stroma: expressions of CA 19-9 and carcinoembryonic antigen in serum and cystic fluid. J Gastroenterol. 1996, 31 (5): 732-736. 10.1007/BF02347626.CrossRefPubMed Lee JH, Chen DR, Pang SC, Lai YS: Mucinous biliary cystadenoma with mesenchymal stroma: expressions of CA 19-9 and carcinoembryonic antigen in serum and cystic fluid. J Gastroenterol. 1996, 31 (5): 732-736. 10.1007/BF02347626.CrossRefPubMed
22.
go back to reference Thomas JA, Scriven MW, Puntis MC, Jasani B, Williams GT: Elevated serum CA 19-9 levels in hepatobiliary cystadenoma with mesenchymal stroma. Two case reports with immunohistochemical confirmation. Cancer. 1992, 70 (7): 1841-1846. 10.1002/1097-0142(19921001)70:7<1841::AID-CNCR2820700706>3.0.CO;2-X.CrossRefPubMed Thomas JA, Scriven MW, Puntis MC, Jasani B, Williams GT: Elevated serum CA 19-9 levels in hepatobiliary cystadenoma with mesenchymal stroma. Two case reports with immunohistochemical confirmation. Cancer. 1992, 70 (7): 1841-1846. 10.1002/1097-0142(19921001)70:7<1841::AID-CNCR2820700706>3.0.CO;2-X.CrossRefPubMed
23.
go back to reference Pinto MM, Kaye AD: Fine needle aspiration of cystic liver lesions. Cytologic examination and carcinoembryonic antigen assay of cyst contents. Acta Cytol. 1989, 33 (6): 852-856.PubMed Pinto MM, Kaye AD: Fine needle aspiration of cystic liver lesions. Cytologic examination and carcinoembryonic antigen assay of cyst contents. Acta Cytol. 1989, 33 (6): 852-856.PubMed
24.
go back to reference Wee A, Nilsson B, Kang JY, Tan LK, Rauff A: Biliary cystadenocarcinoma arising in a cystadenoma. Report of a case diagnosed by fine needle aspiration cytology. Acta Cytol. 1993, 37 (6): 966-970.PubMed Wee A, Nilsson B, Kang JY, Tan LK, Rauff A: Biliary cystadenocarcinoma arising in a cystadenoma. Report of a case diagnosed by fine needle aspiration cytology. Acta Cytol. 1993, 37 (6): 966-970.PubMed
25.
go back to reference Korobkin M, Stephens DH, Lee JK, Stanley RJ, Fishman EK, Francis IR, Alpern MB, Rynties M: Biliary cystadenoma and cystadenocarcinoma: CT and sonographic findings. AJR Am J Roentgenol. 1989, 153 (3): 507-511.CrossRefPubMed Korobkin M, Stephens DH, Lee JK, Stanley RJ, Fishman EK, Francis IR, Alpern MB, Rynties M: Biliary cystadenoma and cystadenocarcinoma: CT and sonographic findings. AJR Am J Roentgenol. 1989, 153 (3): 507-511.CrossRefPubMed
26.
go back to reference Hai S, Hirohashi K, Uenishi T, Yamamoto T, Shuto T, Tanaka H, Kubo S, Tanaka S, Kinoshita H: Surgical management of cystic hepatic neoplasms. J Gastroenterol. 2003, 38 (8): 759-764. 10.1007/s00535-003-1142-7.CrossRefPubMed Hai S, Hirohashi K, Uenishi T, Yamamoto T, Shuto T, Tanaka H, Kubo S, Tanaka S, Kinoshita H: Surgical management of cystic hepatic neoplasms. J Gastroenterol. 2003, 38 (8): 759-764. 10.1007/s00535-003-1142-7.CrossRefPubMed
27.
go back to reference Kinoshita H, Tanimura H, Onishi H, Kasano Y, Uchiyama K, Yamaue H: Clinical features and imaging diagnosis of biliary cystadenocarcinoma of the liver. Hepatogastroenterology. 2001, 48 (37): 250-252.PubMed Kinoshita H, Tanimura H, Onishi H, Kasano Y, Uchiyama K, Yamaue H: Clinical features and imaging diagnosis of biliary cystadenocarcinoma of the liver. Hepatogastroenterology. 2001, 48 (37): 250-252.PubMed
28.
go back to reference Mortele KJ, Ros PR: Cystic focal liver lesions in the adult: differential CT and MR imaging features. Radiographics. 2001, 21 (4): 895-910.CrossRefPubMed Mortele KJ, Ros PR: Cystic focal liver lesions in the adult: differential CT and MR imaging features. Radiographics. 2001, 21 (4): 895-910.CrossRefPubMed
29.
go back to reference Filippi de la Palavesa MM, Vasilescu C, Habersetzer F, Roy C: Biliary cystadenocarcinoma: sonographic and cytologic findings. J Clin Ultrasound. 1999, 27 (4): 210-212. 10.1002/(SICI)1097-0096(199905)27:4<210::AID-JCU9>3.0.CO;2-D.CrossRefPubMed Filippi de la Palavesa MM, Vasilescu C, Habersetzer F, Roy C: Biliary cystadenocarcinoma: sonographic and cytologic findings. J Clin Ultrasound. 1999, 27 (4): 210-212. 10.1002/(SICI)1097-0096(199905)27:4<210::AID-JCU9>3.0.CO;2-D.CrossRefPubMed
30.
go back to reference Lewin M, Mourra N, Honigman I, Flejou JF, Parc R, Arrive L, Tubiana JM: Assessment of MRI and MRCP in diagnosis of biliary cystadenoma and cystadenocarcinoma. Eur Radiol. 2006, 16 (2): 407-413. 10.1007/s00330-005-2822-x.CrossRefPubMed Lewin M, Mourra N, Honigman I, Flejou JF, Parc R, Arrive L, Tubiana JM: Assessment of MRI and MRCP in diagnosis of biliary cystadenoma and cystadenocarcinoma. Eur Radiol. 2006, 16 (2): 407-413. 10.1007/s00330-005-2822-x.CrossRefPubMed
31.
go back to reference Matsuoka Y, Hayashi K, Yano M: Case report: malignant transformation of biliary cystadenoma with mesenchymal stroma: documentation by CT. Clin Radiol. 1997, 52: 318-321. 10.1016/S0009-9260(97)80066-9.CrossRefPubMed Matsuoka Y, Hayashi K, Yano M: Case report: malignant transformation of biliary cystadenoma with mesenchymal stroma: documentation by CT. Clin Radiol. 1997, 52: 318-321. 10.1016/S0009-9260(97)80066-9.CrossRefPubMed
32.
go back to reference Beretta E, De Franchis R, Staudacher C, Faravelli A, Primignani M, Vecchi M, Conti E, Di Carlo V: Biliary cystadenoma: an uncommon cause of recurrent cholestatic jaundice. Am J Gastroenterol. 1986, 81 (2): 138-140.PubMed Beretta E, De Franchis R, Staudacher C, Faravelli A, Primignani M, Vecchi M, Conti E, Di Carlo V: Biliary cystadenoma: an uncommon cause of recurrent cholestatic jaundice. Am J Gastroenterol. 1986, 81 (2): 138-140.PubMed
34.
go back to reference Pelish TL, Roberts JA: Cystadenoma of the biliary system presenting as an abdominal mass in pregnancy. Obstet Gynecol. 1987, 70 (3 Pt 2): 466-468.PubMed Pelish TL, Roberts JA: Cystadenoma of the biliary system presenting as an abdominal mass in pregnancy. Obstet Gynecol. 1987, 70 (3 Pt 2): 466-468.PubMed
35.
go back to reference Pinson CW, Munson JL, Rossi RL, Braasch JW: Enucleation of intrahepatic biliary cystadenomas. Surg Gynecol Obstet. 1989, 168 (6): 534-537.PubMed Pinson CW, Munson JL, Rossi RL, Braasch JW: Enucleation of intrahepatic biliary cystadenomas. Surg Gynecol Obstet. 1989, 168 (6): 534-537.PubMed
Metadata
Title
Emergency laparotomy for misdiagnosed biliary cystadenoma originating from caudate lobe
Publication date
01-12-2006
Published in
World Journal of Surgical Oncology / Issue 1/2006
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-4-76

Other articles of this Issue 1/2006

World Journal of Surgical Oncology 1/2006 Go to the issue