Tsiftsis D, Christodoulakis M, de Bree E, Sanidas E
Department of Surgical Oncology, University of Crete Medical School, Herakleion, Greece.
J Surg Oncol. 1997 Apr;64(4):341-6. doi: 10.1002/(sici)1096-9098(199704)64:4<341::aid-jso17>3.0.co;2-5.
Biliary cystadenoma and cystadenocarcinoma are rare tumors. The clinical features of, and optimal surgical management for these lesions have not been defined clearly. In this report, we describe three cases of cystadenomatous tumors of the biliary tract: two of a cystadenoma and one of a cystadenocarcinoma. The differential diagnosis of the cystic tumors of the liver in countries with a high prevalence of liver hydatid disease is very important.
The authors report their institution's experience from 1988 to 1995 in treating two cystadenomas and one cystadenocarcinoma and review previously reported cases in the literature.
Clinical presentation is usually mild and atypical. During operation, the mass was resected en bloc with a margin of normal liver tissue in the cases of cystadenomas and, in the case of cystadenocarcinoma, a left hepatectomy with drainage of the common bile duct was performed. The two patients with adenomas remain well at 1 and 7 years after operation and our patient with adenocarcinoma is free of disease 8 years later.
The treatment of choice is radical excision of the mass, either with a wide margin of normal liver or by means of a typical lobectomy, depending on the size and location of the lesion. When the lesion can be removed completely, the prognosis is excellent.
胆管囊腺瘤和囊腺癌是罕见肿瘤。这些病变的临床特征及最佳手术治疗方法尚未明确界定。在本报告中，我们描述了三例胆管囊腺瘤性肿瘤：两例为囊腺瘤，一例为囊腺癌。在肝包虫病高发国家，肝脏囊性肿瘤的鉴别诊断非常重要。
作者报告了其机构在1988年至1995年期间治疗两例囊腺瘤和一例囊腺癌的经验，并回顾了文献中先前报道的病例。
临床表现通常较轻且不典型。手术中，囊腺瘤病例的肿块连同正常肝组织边缘整块切除，囊腺癌病例则行左肝切除并进行胆总管引流。两名腺瘤患者术后1年和7年情况良好，我们的腺癌患者8年后无疾病复发。
治疗的选择是根据病变的大小和位置，要么连同正常肝脏的宽边缘进行肿块的根治性切除，要么进行典型的叶切除术。当病变能够完全切除时，预后极佳。
