Differentiating Simple Hepatic Cysts from Mucinous Cystic Neoplasms: Radiological Features, Cyst Fluid Tumour Marker...

Area of Science:

• Hepatobiliary surgery
• Gastroenterology
• Diagnostic imaging

Background:

• Distinguishing hepatic mucinous cystic neoplasms (MCNs) from simple hepatic cysts (SCs) preoperatively poses a diagnostic challenge.
• Accurate preoperative differentiation is crucial for appropriate patient management and surgical planning.

Purpose of the Study:

• To evaluate the efficacy of radiological features, cyst fluid tumor markers, and multidisciplinary team (MDT) outcomes in differentiating MCNs from SCs.
• To identify reliable methods for preoperative diagnosis of cystic liver lesions.

Main Methods:

• Retrospective review of 52 patients with cystic liver lesions.
• Analysis of radiological features on ultrasound scan (USS), CT, and MRI.
• Assessment of cyst fluid tumor marker levels (CA 19-9, CEA, CA 125) and MDT outcomes.

Main Results:

• MCNs were more frequently solitary compared to SCs (p = 0.006).
• MDT conclusions indicating a complex cyst were highly predictive of MCN (p = 0.0007).
• Cyst fluid tumor markers (CA 19-9, CEA, CA 125) did not differentiate between MCNs and SCs.

Conclusions:

• MDT assessment, particularly regarding cyst complexity, is the most valuable tool for differentiating MCNs from SCs.
• Solitary cysts on imaging may also suggest MCN.
• Conventional cyst fluid tumor markers lack diagnostic utility; preoperative discussion by a hepatobiliary MDT is recommended for all suspicious cystic liver lesions.