A Case of Biliary Cystadenocarcinoma Diagnosed during Long-term Follow Up

Abstract

A 69-year-old man was periodically followed up for hepatitis B at our hospital. A simple hepatic cyst was detected in segment 4 of the liver by CT in December 2003. The cystic lesion was found to be increasing in size, and a solid component was detected within the cyst on serial CT scans. The solid component gradually enlarged and was enhanced on CT with contrast medium, which also showed dilatation of the intrahepatic duct in the left lobe. On the basis of these serial changes in CT findings, biliary cystadenocarcinoma was suspected, and left hepatectomy was performed. Examination of the resected specimen showed a papillary lesion inside the cyst. Histopathological examination revealed a mixture of adenoma and adenocarcinoma components in the papillary lesion, without ovarian-like stroma. The postoperative course was uneventful, and no recurrence has been observed in 6 years after the surgery. This case seems to be invaluable in determining the origin of tumors on the basis of CT findings. We reviewed the cases of 12 other biliary cystadenocarcinomas diagnosed during long-term follow up.