Biliary cystadenocarcinoma

Biliary cystadenocarcinomas are rare cystic hepatic neoplasms. They can be thought of as a malignant counterpart of biliary cystadenomas.

There is recognised increased female predilection. Its incidence peak is around 60 years of age.

The clinical symptoms are nonspecific and are not distinctive from benign cystic liver lesions unless an invasive growth of the tumour occurs or distant metastases are present.

The vast majority of these neoplasms are intrahepatic (97%) with a small proportion extrahepatic (3%).

Some biliary cystadenomas may rarely develop into a cystadenocarcinoma 9.

General imaging features

Typically seen as a single multilocular cystic tumour with septal or mural nodules 2,5. Imaging cannot reliably differentiate cystadenoma from cystadenocarcinoma, but the presence of septal nodularity may favour the diagnosis of biliary cystadenocarcinoma versus a biliary cystadenoma 3,7.

Discrete soft tissue masses, thick and coarse calcifications, and heterogeneous CT attenuation or MR intensity within the loculi may also be seen, although these features are nonspecific.

Contrast-enhanced ultrasound demonstrates minimal enhancement since the tumours are largely avascular 10. Abnormally increased vascularity may be present peripherally or in the septa.

At MRI, subtraction images may prove helpful for discerning faint mural or septal enhancement.

Surgical removal of the tumour by complete excision is often the treatment of choice. The overall prognosis is considered better than for other malignant tumours of the liver 8.

Hepatobiliary pathology
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Article Information

rID: 19876
Synonyms or Alternate Spellings:
  • Biliary cystadenocarcinomas
  • Cystadenocarcinoma of biliary system

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