Analysis Of The Diagnosis And Treatment Of Hepatobiliary Cystadenoma:Experience In 16 Cases And Review Of The Literature

Objective To study the diagnosis and treatment of hepatobiliary cystadenoma(BCA),so as to improve the recognition of this disease.Methods The clinical data of 16 cases with pathologically confirmed BCA treated in Qilu Hospital of Shandong University from January 2007 to January 2017 were analyzed retrospectively.Results The 16 patients were 51.7±13.2 years of age at the time of presentation(range,25-69 years old),with 16 females and one male(male female ratio,1:15).The majority of 16 cases presented as upper abdominal discomfort or pain.Preoperative liver function of 14 patients was in the normal range.Serum tumor marker carbohydrate antigen(CA)19-9 levels were tested in 15 patients,6 of 15 cases(40.0%)had values higher than those of the normal range(0-39 U/ml),and the average value was 124.3±94.4 U/ml(range,55.5-310.6 U/ml).Other tumor markers,such as alpha-fetoprotein(AFP)、carcinoembryonic antigen(CEA),were within normal range in all patients.Hepatitis virus markers were negative in all but one patient,who was positive for hepatitis B virus(HBV).Preoperative radiological examinations found the tumors located in the left lobe of the liver in 7 cases(43.8%),right lobe in 5 cases(31.2%),left and right lobes in 2 cases(12.5%),common bile duct in 2 cases(12.5%).Four cases were diagnosed correctly according to imaging examination.15 of 16 cases received surgical resection.Among them,14 patients underwent complete surgical resection,and in one case,open fenestration was carried out because of misdiagnosis.The other one of 16 cases underwent ultrasonically guided percutaneous liver biopsy plus microwave thermal therapy.This patient without a radical resection had recurrence three years after treatment.Postoperative pathological diagnosis was BCA in all the 16 cases,and two of them showed malignant change.Conclusion BCA often occurs in middle-aged women,and locates in left lobe of liver mostly.BCA has no specific clinical symptoms,with high preoperative misdiagnostic rate.In most cases liver function and serum tumor markers are within normal range,so it is difficult to make diagnosis and differential diagnosis among other liver cystic lesions.Radiological examination is necessary for evaluation before operation.Complete resection should be the first choice for treatment to ensure a better prognosis.