Cystadenoma with mesenchymal stroma (CMS) in the liver and bile ducts. A clinicopathologic study of 17 cases, 4 with malignant change.
Biliary cystadenoma is very rare non parasitic benign neoplasm of liver with less than 200 cases reported all over the world in the literature. It mainly occurs in middle aged women, slowly progressive; but cannot be differentiated from cystadenocarcinomas before surgery and should always considered Enucleation. Etiology of these tumors is unknown, but several theories have been proposed. Historically these tumors have beentreated by a variety of techniques including aspiration, fenestration, internal drainage, partial resection. Previously reported series have confirmed a greater than 90% recurrence rate with anything less than complete excision. But Enucleation or hepatic resection is definitive treatment of choice. In addition biliary cystadenoma is a premalignant lesion and only excision can differentiate it from its malignant variety, biliary cystadenocarcinoma. A case of benign biliary cystadenoma with mesenchymal stroma is presented. This tumor was associated with elevated carbohydrate antigen 19-9 (CA19-9) which returned to normal 2 weeks after surgical enucleation.