Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical Cases
Background. Biliary cystadenomas and cystadenocarcinomas are rare cystic tumors of the liver. Complicated differential diagnostics for simple cysts often leads to errors in surveillance of patients with these tumors. Cystadenoma and cystadenocarcinoma should be suspected upon detection of single or...
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| Format: | Article |
| Language: | Russian |
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Ministry of Healthcare of the Russian Federation. “Kuban State Medical University”
2022-12-01
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| Series: | Кубанский научный медицинский вестник |
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| Online Access: | https://ksma.elpub.ru/jour/article/view/2900 |
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| author | Kh. A. Ayvazyan E. D. Kuzminikh T. V. Shevchenko Yu. A. Stepanova O. I. Zhavoronkova D. A. Ionkin V. S. Shirokov A. V. Glotov B. N. Gurmikov A. V. Zhao |
| author_facet | Kh. A. Ayvazyan E. D. Kuzminikh T. V. Shevchenko Yu. A. Stepanova O. I. Zhavoronkova D. A. Ionkin V. S. Shirokov A. V. Glotov B. N. Gurmikov A. V. Zhao |
| author_sort | Kh. A. Ayvazyan |
| collection | DOAJ |
| description | Background. Biliary cystadenomas and cystadenocarcinomas are rare cystic tumors of the liver. Complicated differential diagnostics for simple cysts often leads to errors in surveillance of patients with these tumors. Cystadenoma and cystadenocarcinoma should be suspected upon detection of single or multilocular cystic neoplasms of the liver with septa and blood flow loci in the cyst wall, especially in middle-aged women. The localization of the tumor is critical. The most common localization is segment IV of the liver. Urgent intraoperative biopsy is required to determine the extent of surgery.Case description. Clinical observations with analysis of the examination and treatment data of two female patients aged 38 and 56 were presented. Both clinical observations illustrate the underestimation of the preoperative examination data that served as a ground for diagnosis of liver cysts with inadequate extent of surgery. In the first case, the resection was incomplete, and, as such, the biliary cystadenoma recurred in the resection area, the capsule of the neoplasm was ruptured and an encysted fluid collection was formed. In the second case, lack of histological examination of the excised neoplasm, due to confidence in its morphological verification as a cyst, resulted in cystadenoma recurrence in the resection zone with metastasis to the contralateral lobe of the liver.Conclusion. Hepatic cystadenomas and cystadenocarcinomas are often misdiagnosed as simple cysts. These tumors should be suspected in central localization of the tumor in the liver, especially in young women. The clinical and instrumental symptomatology and radiological semiotics of the disease require careful evaluation. The recurrence of a cystic lesion in the resection zone in a patient previously operated for a hepatic cyst serves as an additional signal for detecting biliary cystadenoma. Rational strategy for surgical management of cystic liver lesions should include hepatectomy within healthy tissues (both anatomical and atypical) with mandatory intraoperative ultrasound and urgent histological examinations. |
| first_indexed | 2024-03-07T21:47:22Z |
| format | Article |
| id | doaj.art-5304dc848b274341b5ae412d4837caa9 |
| institution | Directory Open Access Journal |
| issn | 1608-6228 2541-9544 |
| language | Russian |
| last_indexed | 2025-03-14T11:26:41Z |
| publishDate | 2022-12-01 |
| publisher | Ministry of Healthcare of the Russian Federation. “Kuban State Medical University” |
| record_format | Article |
| series | Кубанский научный медицинский вестник |
| spelling | doaj.art-5304dc848b274341b5ae412d4837caa92025-03-02T10:05:37ZrusMinistry of Healthcare of the Russian Federation. “Kuban State Medical University”Кубанский научный медицинский вестник1608-62282541-95442022-12-01296678310.25207/1608-6228-2022-29-6-67-831338Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical CasesKh. A. Ayvazyan0E. D. Kuzminikh1T. V. Shevchenko2Yu. A. Stepanova3O. I. Zhavoronkova4D. A. Ionkin5V. S. Shirokov6A. V. Glotov7B. N. Gurmikov8A. V. Zhao9Vishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryVishnevsky National Medical Research Center of SurgeryBackground. Biliary cystadenomas and cystadenocarcinomas are rare cystic tumors of the liver. Complicated differential diagnostics for simple cysts often leads to errors in surveillance of patients with these tumors. Cystadenoma and cystadenocarcinoma should be suspected upon detection of single or multilocular cystic neoplasms of the liver with septa and blood flow loci in the cyst wall, especially in middle-aged women. The localization of the tumor is critical. The most common localization is segment IV of the liver. Urgent intraoperative biopsy is required to determine the extent of surgery.Case description. Clinical observations with analysis of the examination and treatment data of two female patients aged 38 and 56 were presented. Both clinical observations illustrate the underestimation of the preoperative examination data that served as a ground for diagnosis of liver cysts with inadequate extent of surgery. In the first case, the resection was incomplete, and, as such, the biliary cystadenoma recurred in the resection area, the capsule of the neoplasm was ruptured and an encysted fluid collection was formed. In the second case, lack of histological examination of the excised neoplasm, due to confidence in its morphological verification as a cyst, resulted in cystadenoma recurrence in the resection zone with metastasis to the contralateral lobe of the liver.Conclusion. Hepatic cystadenomas and cystadenocarcinomas are often misdiagnosed as simple cysts. These tumors should be suspected in central localization of the tumor in the liver, especially in young women. The clinical and instrumental symptomatology and radiological semiotics of the disease require careful evaluation. The recurrence of a cystic lesion in the resection zone in a patient previously operated for a hepatic cyst serves as an additional signal for detecting biliary cystadenoma. Rational strategy for surgical management of cystic liver lesions should include hepatectomy within healthy tissues (both anatomical and atypical) with mandatory intraoperative ultrasound and urgent histological examinations.https://ksma.elpub.ru/jour/article/view/2900hepatic cystsbiliary cystadenomabiliary cystadenocarcinomamucinous cystadenomadiagnosistreatmenthepatectomy |
| spellingShingle | Kh. A. Ayvazyan E. D. Kuzminikh T. V. Shevchenko Yu. A. Stepanova O. I. Zhavoronkova D. A. Ionkin V. S. Shirokov A. V. Glotov B. N. Gurmikov A. V. Zhao Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical Cases Кубанский научный медицинский вестник hepatic cysts biliary cystadenoma biliary cystadenocarcinoma mucinous cystadenoma diagnosis treatment hepatectomy |
| title | Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical Cases |
| title_full | Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical Cases |
| title_fullStr | Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical Cases |
| title_full_unstemmed | Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical Cases |
| title_short | Diagnostic and Treatment Errors in Biliary Cystadenomas and Cystadenocarcinomas: Clinical Cases |
| title_sort | diagnostic and treatment errors in biliary cystadenomas and cystadenocarcinomas clinical cases |
| topic | hepatic cysts biliary cystadenoma biliary cystadenocarcinoma mucinous cystadenoma diagnosis treatment hepatectomy |
| url | https://ksma.elpub.ru/jour/article/view/2900 |
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