Biliary cystadenocarcinoma

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

Epidemiology

There is recognised increased female predilcation. It'sIts incidence peak atis around 60 years of age..

Clinical presenation

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

Pathology

The vast majoitymajority of these neoplasms are intrahepatic (97%) where with a small proportion is 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 septal or mural nodules ^2,5. TheImaging cannot reliably differentiate cystadenoma from cystadenocarcinoma, but the presence of septal nodularity to the septae may may favour towards the diagnosis of biliary cystadenocarcinoma versus a biliary cystadenoma ^3,7.

Discrete soft tissue masses, thick and coarse calcifications, and varying density onheterogeneous CT attenuation or intensity on MRI withinMR intensity within the loculi may also be seen, although these features are non specificnonspecific.

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 of choice. The overall prognosis is considered better than other malignant tumours of the liver ⁸.