Cystic Neoplasms

Question 1

Simple cysts of the liver

Answer 1

contain serous fluid
do not communicate with the biliary tree
do not have septations
considered congenital malformation
Single Thin wall single Cyst

Question 2

when to suspect cystadenoma ?

Answer 2

A thick or nodular wall

Question 3

The most common complication of simple cyst ?

Answer 3

The most common complication is intracystic bleeding

Question 4

Tx options ?

Answer 4

• indicated only if they are symptomatic or diagnostic uncertainty.
• aspiration and injection of a sclerosing agent.
• Surgical therapy is achieved by fenestration or unroofing of the portion of the cyst that is extrahepatic.

Question 5

Cystadenoma of the liver

Answer 5

• rare neoplasm
• manifested as a large cystic mass, usually 10 to 20 cm
• fluid contained > mucinous.
• atypical cuboidal or columnar cells
• with ovarian-like stroma
• epithelium often forms polypoid or papillary projections.

Question 6

Cystadenoma CT and US features?

Answer 6

cystic structure
wall thickness
nodularity
septations
fluid-filled locules
enhancement of the cyst wall and septa.

Question 7

Tx ?

Answer 7

The treatment of cystadenoma or cystadenocarcinoma is complete excision

can be done with an enucleation if there is no evidence of invasive malignant disease.

Incomplete resection risks recurrence or the development of cystadenocarcinoma.

Question 8

Polycystic Liver Disease seen in ?

Answer 8

seen in autosomal dominant inherited adult polycystic kidney disease

Question 9

which come first kidney cyst or liver ?

Answer 9

Liver cysts are always preceded by kidney cysts

Question 10

Their Presence depends on ?

Answer 10

AGE

Question 11

Tx ?

Answer 11

Tx for only Severe Symptoms

• percutaneous aspiration with or without sclerotherapy
• cyst fenestration
• hepatic resection
• orthotopic liver transplantation

Question 12

in the context of renal failure what can you do ?

Answer 12

combined kidney and liver transplantation may be appropriate.

Question 13

Bile Duct Cysts

Answer 13

• Because of the risk of malignancy and recurrent cholangitis
  » treatment is excision with reestablishment of biliary-enteric continuity.
• Most bile duct cysts involve the extrahepatic biliary tree,
• type IV cysts, there is involvement of the extrahepatic bile duct and intrahepatic ducts.
• Caroli disease (type V) is characterized by multiple intrahepatic cysts

Question 14

Tx of Intrahepatic Cyst Focal vs Diffuse?

Answer 14

• localized&raquo_space; hepatic resection, with or without biliary reconstruction
• diffuse hepatic involvement&raquo_space; transplantation.