背景:肝内胆管囊腺瘤是罕见的肝肿瘤,通常是囊性的。由于非特异性的临床和放射学特征,这些肿瘤通常在临床和放射学上被误诊为单纯性肝囊肿和包虫囊肿。这些肿瘤需要完全切除,因为不完全切除后可能发生复发和恶变。必须准确诊断这些肿瘤,以便可以充分切除它们。
方法:描述了6例胆道囊腺瘤的临床和影像学特征。
结果:所有这些病例都切除了单纯性肝囊肿和/或包虫囊肿的临床和/或放射学印象。在六个病人中,五个是女性,一个是男性。患者年龄范围为28至60岁(平均45岁)。患者出现非特异性症状。术前影像学(如有)可观察到内部隔膜。粗略检查,所有肿瘤都是囊性的;它们的大小从5.5到14厘米不等,平均大小为9.0厘米。在组织病理学检查中,囊性间隙由立方体排列为柱状粘蛋白分泌上皮,并带有潜在的卵巢型基质。在一个案例中,未见到卵巢型基质。随访1~5年3例复发。
结论:由于其恶性潜能和不完全切除后的高复发率,建议采用积极的手术方法。完全切除后预后良好。
BACKGROUND: Intrahepatic biliary cystadenomas are rare hepatic neoplasms, which are usually cystic. These tumors are often misdiagnosed as simple liver cysts and hydatid cysts clinically and radiologically owing to nonspecific clinical and radiologic features. These tumors require complete resection, as recurrence and malignant transformation can occur following incomplete excision. It is essential that these tumors be diagnosed accurately so that they can be adequately excised.
METHODS: Clinical and radiological features of six cases of biliary cystadenoma are described.
RESULTS: All of these cases were resected with the clinical and/or radiological impression of simple liver cysts and/or hydatid cysts. Out of the six patients, five were female and one was male. Ages of the patients ranged from 28 to 60 years (mean 45 years). The patients presented with nonspecific symptoms. Internal septations were seen on preoperative imaging (when available). On gross examination, all tumors were cystic; their sizes varied from 5.5 to 14 cm, mean size was 9.0 cm. On histopathologic examination, cystic spaces were lined by cuboidal to columnar mucin-secreting epithelium with underlying ovarian-type stroma. In one case, ovarian-type stroma was not seen. Recurrence was seen in three cases at 1 to 5 years of follow up.
CONCLUSIONS: Owing to their malignant potential and high recurrence rate following incomplete resection, an aggressive surgical approach is recommended. Prognosis is excellent after complete resection.