Biliary cystadenocarcinoma

Abiliary cystadenocarcinoma is a rare rare cystic hepatic neoplasm. It can be thought of as a malignant counterpart of a biliary cystadenoma.

Epidemiology

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

Clinical presenation

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

Pathology

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

Some biliary cystadenomas may rarely develop into a cystadenocarcinoma ⁹.

Radiographic features

General imaging features

Typically seen as a single multilocular cystic tumour with with septal or mural nodules ^2,5. Imaging cannot reliably differentiate cystadenoma from cystadenocarcinoma, but the presence of septal nodularity may 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 attenuation or MR intensity within 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.

Treatment and prognosis

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