1/13. Combined hepatocellular and cystadenocarcinoma presenting as a giant cyst of the liver--a case report.Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular carcinomas (HCC) with a smaller number being cholangiocarcinomas. The association of HCC with other primary liver malignancies is also extremely rare. This case report is about a 27 year old male patient who presented with a giant cystic lesion of the left liver. A CT scan showed a cystic lesion with internal septations and a thrombus in the main portal vein. The patient underwent an extended left hepatectomy and a portal venotomy with removal of the thrombus. Coexistent hepatocellular and cystadenocarcinoma were reported on histopathological examination. The patient was put on 5-FU postoperatively. He is doing well 11 months after surgery.- - - - - - - - - - ranking = 1keywords = cystadenocarcinoma (Clic here for more details about this article) |
2/13. Spontaneous rupture of a nonparasitic liver cyst complicated by intracystic hemorrhage.a case of spontaneous rupture of simple liver cyst complicated by intracystic hemorrhage is described. This rare condition was detected in a 61-year-old man who underwent left trisegmentectomy of liver under a suspected diagnosis of cystadenocarcinoma because of elevated serum levels of carbohydrate antigen (CA) 19-9 and DUPAN 2, and the presence of an intracystic structure. The resected specimen showed a benign liver cyst with intracystic hematoma and high levels of CA19-9 and DUPAN 2 in the cystic fluid. It is suggested that cyst rupture may increase serum levels of tumor markers whose levels are high in the cystic fluid, and that repeated observations of an intracystic structure may be the most reliable method to distinguish intracystic hemorrhage from cystic neoplasm.- - - - - - - - - - ranking = 0.2keywords = cystadenocarcinoma (Clic here for more details about this article) |
3/13. A resected case of combined hepatocellular carcinoma and cholangiocarcinoma associated with cystic formation.Combined hepatocellular carcinoma and cholangiocarcinoma is a rare tumor. In addition, both hepatocellular carcinoma and cholangiocarcinoma are rarely associated with cystic lesions. We herein present a 62-year-old Japanese woman with combined hepatocellular carcinoma and cholangiocarcinoma which was associated with a rapidly enlarging cystic lesion. Both abdominal ultrasonography and computed tomography revealed a cyst with a solid portion in the left hepatic lobe. A partial hepatectomy was performed on the basis of a tentative diagnosis of a cystadenocarcinoma of the liver, while the diagnosis based on immunohistochemical studies was combined hepatocellular carcinoma and cholangiocarcinoma with cystic formation. The patient died of tumor recurrence, such as intrahepatic metastases and extensive lymph node metastases, 6 months after the operation. The prognosis of this entity, which has never been reported in the English medical literature and is difficult to preoperatively differentiate from hepatic cystadenocarcinoma, therefore seems to be extremely poor.- - - - - - - - - - ranking = 0.4keywords = cystadenocarcinoma (Clic here for more details about this article) |
4/13. Clinics in diagnostic imaging (48). Cystic liver metastases.A 51-year-old man presented with an epigastric mass. ultrasonography showed multiple cystic liver masses due to metastases from transitional cell carcinoma. Causes of cystic liver lesions include simple cyst, polyeystic liver disease, abscess, choledochal cyst, biliary cysadenoma and cystadenocarcinoma, and primary liver tumour. The imaging features of various types of cystic liver lesions are reviewed.- - - - - - - - - - ranking = 0.2keywords = cystadenocarcinoma (Clic here for more details about this article) |
5/13. Malignant transformation of biliary cystadenoma: a difficult diagnosis.The case is described of a 63-year-old female with a multilocular liver cyst diagnosed as cystadenoma after imaging and fine needle aspiration. The lesion, however, proved to be an invasive cystadenocarcinoma at surgery. cystadenoma cannot be differentiated, preoperatively, from cystadenocarcinoma and should always be considered for surgical resection.- - - - - - - - - - ranking = 0.4keywords = cystadenocarcinoma (Clic here for more details about this article) |
6/13. Intracystic hemorrhage of a simple liver cyst mimicking a biliary cystadenocarcinoma.Simple liver cysts are rarely complicated by intracystic hemorrhage. We encountered a case of simple liver cyst that was morphologically similar to biliary cystadenocarcinoma, which was complicated by asymptomatic intracystic hemorrhage and successfully treated by right lobectomy. A large cystic lesion of the liver was detected in a 57-year-old woman during a mass screening health check. Abdominal ultrasonography (US) revealed that the cystic lesion, containing many hyperechoic papillary structures, occupied almost the entire region of the right hepatic lobe. In addition, a round mural nodule, measuring approximately 5 cm in diameter, was detected in the cystic wall. Abdominal computed tomography (CT) revealed that the inner part of the cystic lesion showed homogeneous low density, but CT did not show the round nodule detected by US. On T1-weighted sequence of magnetic resonance imaging (MRI), the lesion showed homogeneous high signals, together with a low-signal tumorous lesion in the cystic wall. T2-weighted sequence of MRI showed unhomogeneous high signals, together with high signals in the tumorous part. These findings did not exclude the possibility of a malignant cystic tumor, such as biliary cystadenocarcinoma. Therefore, right lobectomy was performed. Histological examinations of resected tissue specimens revealed that the lesion was a liver cyst containing a large amount of blood clot, and that the tumorous lesion detected by US and MRI was a large mass of blood clot which was partly liquefied. This case indicates the diagnostic importance of the morphological discordance between CT and US or MRI findings for liver cyst containing a large amount of blood clot.- - - - - - - - - - ranking = 1.2keywords = cystadenocarcinoma (Clic here for more details about this article) |
7/13. cystadenocarcinoma of the liver: a case report.BACKGROUND: Biliary cystadenocarcinoma as a very rare hepatic neoplasm may be difficult to distinguish from simple hepatic cysts, especially in the unilocular form. Although diagnosis of cystadenocarcinoma during open hepatic surgery demands a complete surgical resection, few reports described the correct approach to such lesions revealed by laparoscopic approach. Five cases of incidental cystadenocarcinoma after laparoscopic surgery for hepatic cystic lesions were presented with discussion of diagnostic and management implications. methods: Clinical records of 5 patients who had undergone operation and histological examination at our hospital from 1993 to 2002 were analyzed retrospectively. RESULTS: In all patients who received liver lobectomy, primary hepatic cystadenocarcinoma was diagnosed. Primary biliary cystic neoplasm was difficult to diagnose and the management of both benign and malignant tumors was similar in the 5 patients. CONCLUSIONS: cystadenocarcinoma is often difficult to diagnose because its clinical manifestations are similar to those of hepatic cysts and other cystic lesions. Imagining examination is helpful in evaluating the disease. Complete excision of cystadenocarcinoma with a wide margin is the best treatment.- - - - - - - - - - ranking = 1keywords = cystadenocarcinoma (Clic here for more details about this article) |
8/13. Destructive granuloma derived from a liver cyst: a case report.We herein report the case of an idiopathic liver cystic mass which aggressively infiltrated the thoraco-abdominal wall. A 74-year-old woman who had a huge cystic lesion in her right hepatic lobe was transferred to our hospital for further examinations. Imaging studies revealed a simple liver cyst, and the cytological findings of intracystic fluid were negative. She was followed up periodically by computed tomography (CT) scans. Seven years later, she complained of a prominence and dull pain in her right thoraco-abdominal region. CT revealed an enlargement of the cystic lesion and infiltration into the intercostal subcutaneous tissue. We suspected the development of a malignancy inside the liver cyst such as cystadenocarcinoma, and she therefore underwent surgery. A tumor extirpation was performed, including the chest wall, from the 7th to the 10th rib, as well as a right hepatic lobectomy. Pathologically, the lesion consisted of severe inflammatory change with epithelioid cell granuloma and bone destruction without any malignant neoplasm. No specific pathogens were evident based on further histological and molecular examinations. Therefore the lesion was diagnosed to be a destructive granuloma associated with a long-standing hepatic cyst. Since undergoing surgery, the patient has been doing well without any signs of recurrence.- - - - - - - - - - ranking = 0.2keywords = cystadenocarcinoma (Clic here for more details about this article) |
9/13. Cholangiocellular carcinoma associated with multiple liver cysts.A 46-year-old woman visited our outpatient clinic complaining of dull right hypochondrial pain. ultrasonography revealed four cysts in the right lobe of the liver. Arteriography and CT could not determine whether these cysts were benign or malignant. Because one of these cysts contained chocolate-colored fluid, amebic abscess was suspected, and the cyst was drained. No amebae were found in the cultured exudate, and fresh bleeding continued; therefore, laparotomy was performed. A tumor was present on the surface of the liver. Right lobectomy was performed. The resected specimen contained one nonepithelialized cyst which was invaded by surrounding cholangiocellular carcinoma and three epithelialized cysts. Preoperative diagnosis of this kind of cholangiocellular carcinoma seems to be very difficult. Recently cholangiocellular carcinoma associated with developmental cysts has been classified as a new entity different from cystadenocarcinoma. cholangiocarcinoma, which belongs to this group, seems to deserve special attention.- - - - - - - - - - ranking = 0.2keywords = cystadenocarcinoma (Clic here for more details about this article) |
10/13. cholangiocarcinoma coexisting with developmental liver cysts: a distinct entity different from liver cystadenocarcinoma.We report one liver cystadenocarcinoma and two cholangiocarcinomas coexisting with developmental liver cysts. The cystadenocarcinoma was a solitary multilocular cyst with histological features similar to those seen in ovarian mucinous cystadenocarcinoma. In contrast, the other two tumours were a mixture of solid adenocarcinoma and multiple non-neoplastic cysts containing serous fluid and lined mainly by atrophic epithelium. In both these cases renal cysts were also present and in one case there was focal malignant change of the epithelium lining the cysts from which the solid adenocarcinoma could have originated. Our observations support the view that cholangiocarcinoma associated with developmental liver cysts is an entity different from liver cystadenocarcinoma.- - - - - - - - - - ranking = 1.6keywords = cystadenocarcinoma (Clic here for more details about this article) |
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