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Surgical management of biliary cystadenoma and cystadenocarcinoma of the liver.
- Source :
-
Genetics and molecular research : GMR [Genet Mol Res] 2014 Aug 25; Vol. 13 (3), pp. 6383-90. Date of Electronic Publication: 2014 Aug 25. - Publication Year :
- 2014
-
Abstract
- Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) are rare biliary duct neoplasms. This study investigated reasonable management strategies of cystic neoplasms in the liver. Charts of 39 BCA/BCAC patients (9 males, 30 female; median age 53.74 ± 14.50 years) who underwent surgery from January 1999 to December 2009 were reviewed retrospectively. Cyst fluid samples of 32 BCA/BCAC patients and 40 simple hepatic cyst patients were examined for the tumor markers carbohydrate associated antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). The most frequent symptoms were abdominal pain (N = 10), abdominal mass (N = 7), abdominal distension (N = 4), jaundice (N = 2), and fever (N = 3); the remaining patients showed no clinical symptoms. Liver resection (N = 17) or enucleation (N = 22) was performed in the 39 patients. Ultimately, 35 patients were diagnosed with intrahepatic BCA and four patients were diagnosed with BCAC. The median CA19-9 level was significantly higher in BCA/BCAC patients than in simple hepatic cyst patients. The median CEA levels in BCA/BCAC patients and controls were 6.83 ± 2.43 and 4.21 ± 2.91 mg/L, respectively. All symptoms were resolved after surgery, and only one BCAC patient showed recurrence. The incidence of intrahepatic cystic lesions was 1.7%. Increased CA19-9 levels in the cyst fluid is a helpful marker for distinguishing BCA/BCAC from common simple cysts. The presence of coarse calcifications is suggestive of BCAC. Complete surgical removal of these lesions yielded satisfying long-term outcomes with a very low recurrence rate.
- Subjects :
- Adult
Aged
Antigens, Tumor-Associated, Carbohydrate genetics
Bile Ducts metabolism
Bile Ducts pathology
Bile Ducts physiopathology
Biliary Tract Neoplasms metabolism
Biliary Tract Neoplasms pathology
Biliary Tract Neoplasms physiopathology
Carcinoembryonic Antigen genetics
Cystadenocarcinoma metabolism
Cystadenocarcinoma pathology
Cystadenocarcinoma physiopathology
Cystadenoma metabolism
Cystadenoma pathology
Cystadenoma physiopathology
Female
Gene Expression
Humans
Liver metabolism
Liver pathology
Liver physiopathology
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Bile Ducts surgery
Biliary Tract Neoplasms surgery
Biomarkers, Tumor genetics
Cystadenocarcinoma surgery
Cystadenoma surgery
Liver surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1676-5680
- Volume :
- 13
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Genetics and molecular research : GMR
- Publication Type :
- Academic Journal
- Accession number :
- 25158256
- Full Text :
- https://doi.org/10.4238/2014.August.25.1