Abstract
We report an extremely rare case of biliary cystadenocarcinoma the natural history of which was retrospectively reviewed based on CT findings. A 79-year-old man was found to have a 13 x 8-cm hepatic cystic tumor with intraluminal papillary projection and extraluminal nodules in the left lobe and right anterior segment. Cholangiography revealed no communication between the cystic tumor and biliary tract. The liver cystic tumor had been identified on a CT series performed for follow-up of lung cancer surgery during the previous 10 years. The natural history from tumor origination to invasive cystaden-ocarcinoma was observed on those films. After surgical resection the histological diagnosis was biliary cystadenocarcinoma with invasion to the liver parenchyma. Low grade atypical mucosa, which was immunohistochemically positive for both CK17 and hepatocyte-paraffin 1, was observed in the cystic tumor. There was no ovarian-like stroma. He is alive 16 months after surgery without any signs of recurrence. This case may be valuable in considering the origins of the tumor based on CT findings as well as immunohistochemical findings. We reviewed 15 other cases of hepatic cystadenocarcinoma with neither ovarian-like stroma nor biliary tract communication reported in the literature.
