Cystadenomas of the fiver: a spectrum of disease

Objectives: To describe the vide variation in presentation of cystadenomas of the liver and to delineate useful tests for diagnosis and effective surg ical treatment. Design: A case series. Setting: A university-affiliated hos pital. Patients: Four patients (3 women, 1 man) having cystadenoma of the l iver, 2 of whom had associated mesenchymal stroma. Main outcome measures: S erum and cyst fluid carcino-embryonic antigen (CEA) and CA19-9 levels, type of surgery, morbidity and recurrence rates. Results: Cyst fluid CEA and CA 19-9 levels were elevated. One patient had resection, 2 had complete enucle ation and I had partial enucleation. There were no deaths. Morbidity includ ed 1 wound infection; there were no biliary fistulas, The patient with part ial enucleation had a radiologically confirmed recurrence. Conclusions: Ana lysis of cyst fluid CEA and CA19-9 is useful for diagnosis; besides hepatic resection, complete enucleation should be considered as a reasonable treat ment for patients with this disease.