Hepatobiliary cystadenoma: a report of two cases

We report two cases of hepatobiliary cystadenoma. Case 1. A 58-year-old male presented with dull abdominal pain and recurrent jaundice. Abdominal echo revealed biliary tracts dilatation; ERCP revealed amorphous filling defect inside the dilated CBD, a cystic tumor in the left lobe communicated with bile duct was disclosed by MRI/MRCP. He received left lobectomy and microscopic findings proved hepatobiliary cystadenoma. Case 2. Abdominal ultrasound detected a huge cystic tumor over the left hepatic lobe in a 69-year-old male. Abdominal CT revealed a large cystic mass lesion over the left hepatic lobe with septations and multiple papillary projections. A liver biopsy was performed and microscopic findings proved biliary cystadenoma. An abdominal ultrasound 6 months later revealed intrahepatic spread of cystadenocarcinoma over both lobes. Hepatobiliary cystadenoma is a rare benign cystic tumor of the liver. It usually occurs in middle-aged women and can undergo malignant change and become lethal. It is frequently misdiagnosed and should be suspected when a uni- or multilocular cystic lesion with papillary infoldings is detected in the liver by CT or ultrasound. ERCP/MRCP have a role in pre-operative evaluation. Elevated serum and cystic fluid tumor markers CA19-9 are only seen in some patients; cystic fluid cytology does not provide adequate diagnostic aid. Its morphologic features maybe confused with biliary papillomatosis or IPMN of bile duct. Its prognosis is excellent after complete resection.