Oh Tae Hoon, Kim Myung Hwan, Lee Sung Koo, Seo Dong Wan, Lee Sang Soo, Kim Eui Young, Song Ju Hyung, Jung Ji Hoon, Lee Sang Ah, Lee Sung Gyu, Park So Hyung, Jang Se Jin
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2006 May;47(5):379-85.
BACKGROUND/AIMS: Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCACa) are rare cystic neoplasms that usually arise from the liver. We reviewed the clinicopathologic and radiologic findings of 13 cases of intrahepatic biliary cystic neoplasms.
Seven patients with BCA and 6 patients with BCACa which were pathologically proven within past 10 years were included in this retrospective study.
BCA (7 of 7) was more common in female compared to BCACa (4 of 6). Mean age at diagnosis was 53.4 years (BCA) and 58.5 years (BCACa). Abdominal pain (54%) was the most common presenting symptom. Eleven patients (61.5%) exhibited normal liver function profiles and 5 patients (38%) showed elevated levels of serum CA19-9 levels (mean 894.2 U/mL, range: 78.7-2,080). Mean size of tumor was 11.7 cm (range: 5-15). Most frequent radiologic finding was a single cystic mass with septation. BCACa tended to have intracystic solid portion. The cut surface revealed a unilocular or multilocular cystic mass with mucinous contents. Complete surgical excision was done in 12 patients. After the complete resection, recurrence was observed in 1 case of BCACa.
The possibility of biliary cystic neoplasm should be suspected when an intrahepatic cystic lesion with multiseptation or solid portion is noted on imaging study. In addition, complete excision for definite diagnosis and treatment need to be performed.
背景/目的:胆管囊腺瘤(BCA)和胆管囊腺癌(BCACa)是罕见的囊性肿瘤,通常起源于肝脏。我们回顾了13例肝内胆管囊性肿瘤的临床病理和影像学表现。
本回顾性研究纳入了过去10年内经病理证实的7例BCA患者和6例BCACa患者。
与BCACa(6例中的4例)相比,BCA(7例中的7例)在女性中更为常见。诊断时的平均年龄为53.4岁(BCA)和58.5岁(BCACa)。腹痛(54%)是最常见的首发症状。11例患者(61.5%)肝功能检查正常,5例患者(38%)血清CA19-9水平升高(平均894.2 U/mL,范围:78.7-2080)。肿瘤平均大小为11.7 cm(范围:5-15)。最常见的影像学表现是单个有分隔的囊性肿块。BCACa往往有囊内实性部分。切面显示为单房或多房囊性肿块,内含黏液性内容物。12例患者进行了完整的手术切除。完全切除后,1例BCACa患者出现复发。
当影像学检查发现肝内有带多个分隔或实性部分的囊性病变时,应怀疑胆管囊性肿瘤的可能性。此外,需要进行完整切除以明确诊断和治疗。