Introduction: Hepato-biliary cystadenomas are rare intrahepatic cystic tumours. The correct preoperative diagnosis of this lesion is difficult.
Methods: We report four cases of hepato-biliary cystadenoma treated in our department from January 1995 to December 1999.
Results: The symptoms were unspecific. Preoperative computed tomography showed signs of an echinococcal cystic lesion in two patients, but there were no antibodies against an echinoccocal species in the serum. We performed a complete resection of the cystic tumour in three patients and a subtotal resection of a hepato-biliary cystadenoma in one, because of involvement of the hepatic portal structures. We did not find a malignant transformation to a hepato-biliary cystadenocarcinoma.
Conclusion: Complete excision of a cystadenoma with a wide margin of normal liver tissue is the treatment of choice, because several reports have described malignant transformation of this kind of tumour. Taking a rapidly frozen section during the operation is an important step in the treatment of cystic liver lesions. A cystic liver lesion with several walls and a elevated CA 19-9 can predict a mucinous cystadenoma or cystadenocarcinoma.