Mucinous Cystic Neoplasm or Non-Parasitic Liver Cyst? - A Challenging Diagnosis

作者：Wahba Roger^*; Kleinert Robert; Dieplinger Georg; Bangard Christopher; Drebber Uta; Hoelscher Arnulf H; Stippel Dirk L

来源：Hepato-Gastroenterology, 2013, 60(123): 585-589.

DOI：10.5754/hge12670

• Mucinous cystic neoplasm
• Non-parasitic liver cyst
• Recurrence
• Diagnosis
• Surgery

Background/Aims: Mucinous cystic neoplasms (MCN) are rare liver lesions. Radiological features include internal septa or septal thickening. Imaging often fails in the differential diagnosis to non-parasitic liver cysts (NPLC), resulting in inadequate surgery. The aim of the study was to evaluate if both lesions could be differentiated pre-operatively. Methodology: Retrospective study with literature review. Results: Twenty-six patients (22 female, 68 +/- 12 years) underwent laparoscopic deroofing for NPLC. Histopathological specimens showed 2 MCN (both female) with recurrence rates of 4% (NPLC) and 100% (MCN), and a time-to-recurrence of 3 months. In both cases no radiological features of MCN were seen. pre-operatively. Follow-up time was 7 and 12 years with emergence of radiological features of MCN in one case. PubMed search showed 137 hits for %26quot;MCN%26quot; and 540 hits for %26quot;mucinous cystadenoma%26quot; and %26quot;liver%26quot;; 207 studies were reviewed: one prospective, 13 non-systematic reviews, 57 retrospective, 120 case reports and 16 expert opinions. The largest MCN-series included 44 subjects. Conclusions: If MCN shows no characteristic radiological features, thus mimicking NPLC, pre-operative radiological differentiation is impossible. During long time course characteristic radiological morphology of MCN could appear. Early recurrence of a supposed NPLC is suspicious for MCN. Due to the literature review pre-operative imaging is inaccurate for the differential diagnosis and complete surgical excision of MCN is crucial.

• 出版日期2013-5