Biliary cystadenoma and cystadenocarcinoma

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Biliary cystadenoma and cystadenocarcinoma
Biliary cystadenoma
(Image courtesy of RadsWiki)

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Overview

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Classification

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Differentiating Biliary cystadenoma and cystadenocarcinoma from other Diseases

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Biliary cystadenoma and cystadenocarcinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging | History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Overview

Biliary cystadenomas are uncommon unilocular or multilocular cystic neoplasms that may occur within the liver (infrequently found in the extrahepatic biliary tree and gallbladder).

Although biliary cystadenomas are benign tumors, they may recur after excision and have potential to develop into biliary cystadenocarcinoma.

Pathophysiology

Microscopic Pathology

At histologic analysis, cystadenomas have multiple loculations lined by cuboidal or columnar epithelium that resembles biliary epithelium.

Differenting Biliary cystadenoma and cystadenocarcinoma from other Diseases

The differential diagnosis principally includes

Epidemiology and Demographics

Cystadenomas occur predominantly in middle-aged women.

Diagnosis

History and Symptoms

The clinical presentation is variable, depending on the size and location of the cyst. Abdominal pain, obstructive jaundice, palpable mass, increasing abdominal girth, nausea, and vomiting are common signs and symptoms.

Biliary cystadenomas range in size from 3 to 40 cm. Large cystadenomas may demonstrate mass effect on adjacent organs or may be associated with hepatomegaly.

Computed Tomography

There are no specific imaging features that permit reliable differentiation of biliary cystadenoma from cystadenocarcinoma.

  • The CT attenuation of the fluid component in a biliary cystadenoma varies depending on the fluid content.
  • Higher attenuation may indicate recent hemorrhage.
  • Calcifications that may be present in the septa or cyst wall are typically more apparent with CT than other imaging modalities.
  • Septa may enhance with contrast material.

(Images courtesy of RadsWiki)

MRI

There are no specific imaging features that permit reliable differentiation of biliary cystadenoma from cystadenocarcinoma.

  • The MR signal intensity of biliary cystadenoma is variable on both T1- and T2-weighted images, depending on the content of the cyst fluid.

Ultrasound

There are no specific imaging features that permit reliable differentiation of biliary cystadenoma from cystadenocarcinoma.

  • At US, a biliary cystadenoma appears as a unilocular or multilocular cyst with enhanced through transmission.
  • Acoustic shadowing may be present from septal or wall calcification.
  • The cyst fluid may contain low-level echoes from blood products, mucin, or proteinaceous fluid. Serous and bilious cyst fluid is generally anechoic.
  • Echogenic mural nodules and papillary projections may be present.

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