Hepatobiliary cystic tumors. Clinical, radiological and histopathological study of 7 cases

Objectives - Hepatobiliary cystic tumors are rare, but must be correctly di agnosed because of their potential malignancy. We report the clinical, radi ological pathological and evolutive characteristics of 7 cases of hepatobil iary cystic tumors. Material and methods - Complete clinical charts were available. Radiologica l and pathological documents were reviewed Results - There were 4 females and 3 males (median age, 58.7 yrs). In 3 cas es, the presenting symptom was the palpation of a mass in the right upper a bdominal quadrant. In 6 cases, pre-operative imaging studies showed a cysti c intra-hepatic mass, containing vegetations and/or septa in 5 cases. In th e remaining case, the radiological appearance showed a heterogeneous liver mass. Two patients were treated by pericystectomy and 5 by radical hepatect omy. At macroscopic examination, tumors were usually large (range : 2-24 cm ) and multilocular. Histological diagnosis was : cystadenoma with mesenchym ous stroma (2 cases), mucinous cystadenoma (2 cases), mucinous; cystadenoca rcinoma (2 cases), giant cell cystadenocarcinoma (I case). The mean duratio n of follow up was 60 months. Two patients, both with cystadenocarcinomas, died after respectively, 21 and 34 months with metastatic dissemination. Fi ve patients are alive without evidence of disease after a delay ranging fro m 14 to 14.4 months. Conclusion - Radical surgical treatment of cystic hepatobiliary tumors is n ecessary to obtain histopathological examination of the complete specimen, which is essential for a correct evaluation of the malignant potential of t he lesion, and for prolonged survival, even in cases of locally invasive tu mors.