Lee Jae Hoon, Lee Kyeong Geun, Park Hwon Kyum, Lee Kwang Soo
Department of Surgery, College of Medicine, Hanyang University, Seoul, Korea.
Hepatogastroenterology. 2009 May-Jun;56(91-92):844-9.
BACKGROUND/AIMS: Biliary cystadenoma and cystadenocarcinoma constitute less than 5% of intrahepatic cysts originating from the bile duct. The aims of this study were to characterize the clinical and pathologic aspects of these lesions, and also to discuss the treatment and prognosis of them.
We reviewed the clinical records of six patients with intrahepatic biliary cystadenoma and four patients with cystadenocarcinoma who had undergone operation from January, 1990 to January, 2006 at Hanyang University Medical Center.
Biliary cystadenoma mainly affected women compared to biliary cystadenocarcinoma. Both tumor have nonspecific symptom and were usually diagnosed by computed tomography and ultrasonography. These tumors were usually large, multilocular, and cystic in appearance. The pathologic findings revealed multiple cystic masses lined with cuboidal to columnar epithelium. The nature of cystic fluid was mostly mucous type. Of 10 patients in whom the lesions were completely excised, 8 patients are alive.
Surgical resection of the tumor, including a margin of surrounding normal liver parenchyma, was the only curative method. Any therapy short of complete excision leads to local recurrence and risk of malignant transformation. Complete resection of a biliary cystadenoma and radical resection of a biliary cystadenocarcinoma seems to offer a chance for long-term survival.
背景/目的:胆管囊腺瘤和囊腺癌占肝内胆管源性囊肿的比例不到5%。本研究的目的是描述这些病变的临床和病理特征,并讨论其治疗方法和预后。
我们回顾了1990年1月至2006年1月在汉阳大学医学中心接受手术的6例肝内胆管囊腺瘤患者和4例囊腺癌患者的临床记录。
与胆管囊腺癌相比,胆管囊腺瘤主要影响女性。两种肿瘤均有非特异性症状,通常通过计算机断层扫描和超声检查诊断。这些肿瘤通常较大,呈多房性,外观为囊性。病理检查发现多个囊性肿块内衬立方形至柱状上皮。囊液性质多为黏液型。10例病变完全切除的患者中,8例存活。
手术切除肿瘤,包括切除周围正常肝实质边缘,是唯一的治愈方法。任何不完全切除的治疗都会导致局部复发和恶变风险。胆管囊腺瘤的完全切除和胆管囊腺癌的根治性切除似乎为长期生存提供了机会。