Search Our Scientific Publications & Authors

Clin Imaging 2021 Aug 3;76:46-52. Epub 2021 Feb 3.

Massachusetts General Hospital, Department of Radiology, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Purpose: The purpose of this study was to determine if CT and MRI features can accurately differentiate mucinous cystic neoplasms (MCNs) from simple liver cysts and to compare accuracy of CT and MRI in detecting these features.

Methods: Eighty-four surgically treated lesions with pre-operative CT or MRI were evaluated by two abdominal radiologists for upstream biliary dilatation, perfusional change, internal hemorrhage, thin septations, thick septations/nodularity, lobar location, and number of coexistent liver cysts. Odds ratios, sensitivities, specificities, and positive and negative predictive values were calculated for association of each feature with MCNs. Read More

Dig Dis Sci 2021 Jan 6. Epub 2021 Jan 6.

Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Clin J Gastroenterol 2021 Feb 20;14(1):258-262. Epub 2020 Nov 20.

Department of Digestive Surgery, CHU Amiens and University of Picardie, 1 rue du Professeur Christian Cabrol, 80054, Amiens cedex, France.

Simple hepatic cysts are very common, but may be difficult to differentiate from a biliary cystadenoma or cystadenocarcinoma. Because the surgical treatment if needed, such as a hepatic fenestration or resection, depends on the diagnosis, the assay of intracystic tumor markers is useful.We report the case of a 67-year-old woman with a large hepatic cyst responsible of pain and inflammation. Read More

J Gastrointest Surg 2021 01 20;25(1):77-84. Epub 2020 Oct 20.

Department of Surgery, University of California San Francisco, 533 Parnassus Avenue, Room 370, San Francisco, CA, USA.

Background: Hepatic cyst disease is often asymptomatic, but treatment is warranted if patients experience symptoms. We describe our management approach to these patients and review the technical nuances of the laparoscopic approach.

Methods: Medical records were reviewed for operative management of hepatic cysts from 2012 to 2019 at a single, tertiary academic medical center. Read More

Clin J Gastroenterol 2021 Feb 29;14(1):212-217. Epub 2020 Sep 29.

Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.

A 22-year-old man was referred for upper abdominal pain. Unenhanced computed tomography (CT) revealed a lesion of heterogeneous hypoattenuation, part of which showed slightly high-density in the porta hepatis. On magnetic resonance imaging (MRI), T1-weighted images showed a multiloculated hyperintense mass and part of the mass was hyperintense in T2-weighted images. Read More

J Clin Transl Hepatol 2019 Jun;7(2):149-153

Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Health Center, Farmington, CT, USA.

Biliary mucinous cystadenomas are cystic neoplasms commonly mistaken for simple cysts. They are rare and generally benign tumors, often incidentally found on imaging and during unrelated surgical interventions. They tend to be slow growing though may reach symptomatic dimensions. Read More

HPB (Oxford) 2019 10 10;21(10):1257-1267. Epub 2019 May 10.

Erasmus MC, University Medical Center Rotterdam, Department of Surgery, Rotterdam, the Netherlands. Electronic address:

Background: Biliary Cystadenomas (BCA) are considered to be benign but may transform to Biliary Cystadenocarcinomas (BCAC). The aim of this systematic review was to assess the diagnostic work-up and necessity of complete surgical resection.

Method: A systematic literature search was performed in Embase. Read More

J Feline Med Surg 2019 01;21(1):12-24

Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK.

Practical Relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the liver can be key in the diagnosis of diseases such as hepatic lipidosis and hepatic neoplasia.

Clinical Challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Read More

Am J Surg Pathol 2018 Jan;42(1):95-102

Department of Pathology, Medical College of Wisconsin Milwaukee, WI, USA.

The literature is highly conflicting on hepatobiliary mucinous cystic neoplasms (MCNs), aka "hepatobiliary cystadenoma/cystadenocarcinoma," largely because ovarian stroma (OS) was not a requirement until WHO-2010 and is not widely applied even today. In this study, MCNs (with OS) accounted for 24 of 229 (11%) resected hepatic cysts in one institution. Eight of the 32 (25%) cysts that had been originally designated as hepatobiliary cystadenoma/cystadenocarcinoma at the time of diagnosis proved not to have an OS during this review and were thus re-classified as non-MCN. Read More

Ann Hepatobiliary Pancreat Surg 2017 Aug 31;21(3):107-113. Epub 2017 Aug 31.

Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Backgrounds/aims: Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) account for 5%-10% of liver cystic diseases. In this study, we analysed the clinical presentation and surgical management of patients with BCA and BCAC.

Methods: We retrospectively analysed the medical records of 23 BCA and 7 BCAC cases diagnosed between January 2007 and December 2013. Read More

Scand J Gastroenterol 2017 Mar 25;52(3):365-372. Epub 2016 Nov 25.

b Med. Klinik 2, Caritas-Krankenhaus Bad Mergentheim , Bad Mergentheim , Germany.

Objective: Hepatic (biliary) cystic tumor (HBCT) is a rare focal cystic liver lesion, which has been rarely described in the literature. In our current multicenter, retrospective study, we aimed to analyze contrast enhanced ultrasound (CEUS) features and its diagnostic performance in histologically proved HBCT.

Material And Methods: Twenty-three patients with single HBCT were retrospectively analyzed. Read More

Khirurgiia (Mosk) 2016(10):27-40

Vishnevsky Institute of Surgery, Health Ministry of the Russian Federation, Moscow, Russia.

Aim: To optimize diagnostics and treatment of cystic liver tumors.

Material And Methods: The analysis included outcomes of 46 patients with liver cystic tumors.

Results And Discussion: The use of abdominal Doppler-sonography (37 patients), abdominal contrast-enhanced CT (44 patients) and MRI of abdominal cavity with MR-cholangiography (24 patients) defined radiological semiotics of cystic liver diseases. Read More

Pancreatology 2016 Jul-Aug;16(4):625-31. Epub 2016 Apr 7.

From the Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China. Electronic address:

Background/objective: Acinar cell cystadenoma (ACA), also referred to as "acinar cystic transformation", is a rare and newly recognized cystic lesion of the pancreas displaying apparent acinar cell differentiation with benign outcomes. We summarized our experience with the diagnosis, clinicopathologic feature, treatment and prognosis of ACA to provide a reference for the disposal of this uncommon condition.

Methods: We retrospectively analyzed the clinical data from eight patients with ACA treated in our hospital between March, 2005 and January, 2015. Read More

Ann Hepatol 2016 May-Jun;15(3):448-52

Department of Gastroenterology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra, India.

Cystic lesions of the liver are common and a major proportion is formed by parasitic cysts and simple cysts. Biliary cystic tumors (BCTs), namely biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC), are rare tumors which usually arise from the intrahepatic biliary tree. BCAs have malignant potential and are difficult to differentiate from BCAC pre-operatively on radiological imaging. Read More

Nan Fang Yi Ke Da Xue Xue Bao 2015 Aug;35(8):1097-102

Department of Hepatobiliary Surgery, General Hospital of PLA, Beijing 100853, China. E-mail:

Objective: To analyze the clinicopathological characteristics and the factors affecting the prognosis of intrahepatic biliary cystadenocarcinoma (IBC).

Methods: Forty-six patients with histologically confirmed IBC from January, 2000 to April, 2014 were included. The clinical characteristics of the patients with IBC were compared with those of 58 patients with intrahepatic biliary cystadenoma (IBCA). Read More

HPB (Oxford) 2015 Oct 30;17(10):889-95. Epub 2015 Jul 30.

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Background: Biliary cystic tumours (BCT) [biliary cystadenoma (BCA) and cystadenocarcinoma (BCAC)] warrant complete resection. Simple liver cysts (SLC) require fenestration when symptomatic. Distinguishing between BCT and atypical SLC with pre-operative imaging is not well studied. Read More

BMC Gastroenterol 2015 Jun 10;15:67. Epub 2015 Jun 10.

Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.

Background: Intrahepatic biliary mucinous cystic neoplasms are rare hepatic tumors and account for less than 5% of intrahepatic cystic lesions. Accurate preoperative diagnosis is difficult and the outcome differs among various treatment modalities.The aim of this study is to investigate the clinico-radiological characteristics of intrahepatic biliary mucinous cystic neoplasms and to establish eligible diagnostic and treatment suggestions. Read More

Chin Med J (Engl) 2015 May;128(9):1177-83

Department of Hepatobiliary Surgery, People's Liberation Army General Hospital, Beijing 100853, China.

Background: Surgical resection is generally considered the main curative treatment for intrahepatic biliary cystadenocarcinoma (IBCA) or suspected IBCAs, but controversy exists regarding the prognosis for IBCAs. This study aimed to describe the clinicopathological characteristics of IBCA and identify prognostic factors that may influence the survival of patients treated with surgical procedures.

Methods: Thirty-four patients with histologically confirmed IBCA treated between January 2000 and June 2014 were included. Read More

World J Gastroenterol 2014 Sep;20(35):12595-601

Fu-Bo Zhang, Ai-Min Zhang, Zhi-Bin Zhang, Xin Huang, Xi-Tao Wang, Jia-Hong Dong, Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China.

Aim: To investigate preoperative differential diagnoses made between intrahepatic biliary cystadenoma and intrahepatic biliary cystadenocarcinoma.

Methods: A retrospective analysis of patient data was performed, which included 21 cases of intrahepatic biliary cystadenoma and 25 cases of intrahepatic biliary cystadenocarcinoma diagnosed between April 2003 and April 2013 at the General Hospital of PLA. Potential patients were excluded whose diagnoses were not confirmed pathologically. Read More

Ann Surg 2015 Feb;261(2):361-7

*Departments of Surgery at Johns Hopkins University School of Medicine, Baltimore, MD †Royal Prince Alfred Hospital, Sydney, Australia ‡Mayo Clinic, Rochester, MN §Emory University School of Medicine, Atlanta, GA ¶University of Pittsburgh, Pittsburgh, PA ‖Medical College of Wisconsin, Milwaukee, WI **Fundeni Institute, Bucharest, Romania ††University of Virginia, Charlottesville, VA ‡‡Ohio State Wexner Medical Center, Columbus, OH; and §§Curry Cabral Hospital, Lisbon, Portugal.

Objective: To characterize clinical and radiological features associated with biliary cystic tumors (BCTs) of the liver, and to define recurrence-free and overall survival.

Background: Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCAC) are rare tumors that arise in the liver.

Methods: Between 1984 and 2013, 248 patients who underwent surgical resection of BCA or BCAC were identified. Read More

World J Gastroenterol 2013 Oct;19(37):6310-4

Zhen-Zhen Yang, Yong Li, Jun Liu, Kuang-Fan Li, Ye-Hong Yan, Wei-Dong Xiao, Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.

Biliary cystadenoma (BCA) is a rare hepatic neoplasm. Although considered a benign cystic tumor of the liver, BCA has a high risk of recurrence with incomplete excision and a potential risk for malignant degeneration. Correct diagnosis and complete tumor excision with negative margins are the mainstay of treatment. Read More

J Am Coll Surg 2014 Jan 14;218(1):119-28. Epub 2013 Sep 14.

Division of Surgical Oncology, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address:

Ultraschall Med 2012 Dec 15;33(7):E241-E249. Epub 2012 Nov 15.

Department of Medical Ultrasound, Tenth People's Hospital of Tongji University.

Purpose: To investigate the imaging features of intrahepatic biliary cystadenoma and cystadenocarcinoma on B-mode and contrast-enhanced ultrasound.

Materials And Methods: The B-mode and contrast-enhanced ultrasound features of 6 intrahepatic biliary cystadenomas and 7 intrahepatic biliary cystadenocarcinomas were retrospectively analyzed, and the differences between cystadenomas and cystadenocarcinomas were compared.

Results: There were no significant differences between cystadenomas and cystadenocarcinomas in terms of patient gender, age, lesion location, size, and shape (all p > 0. Read More

AJR Am J Roentgenol 2011 Nov;197(5):1111-20

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Republic of Korea.

Objective: Intraductal papillary neoplasm (IPN) of the bile duct is a newly described pathologic entity characterized by the presence of intraluminal tumors, which sometimes produce a large amount of mucin and form a cystic tumor. Cystic IPN of the bile duct is different from biliary cystadenoma or cystadenocarcinoma in that the former produces intraductal microscopic and macroscopic papillary tumors without ovarian-like stroma, whereas the latter produce a mucin-containing septate cystic tumor without communication with bile duct and with ovarian-like stroma in the cyst wall. The purpose of this study was to evaluate the potential relationships between cyst-forming IPNs of the bile duct and peribiliary glands and also intraductal papillary mucinous neoplasms of the pancreas. Read More

Liver Int 2011 Oct 13;31(9):1337-44. Epub 2011 Jun 13.

Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & PUMC, Beijing, China

Background: Hepatobiliary cystadenomas and cystadenocarcinomas are rare and often misdiagnosed.

Aims: We report our experience with 33 cases over 20 years to discuss an algorithm for these diseases.

Methods: Patients presenting with a diagnosis of hepatobiliary cystadenomas and cystadenocarcinomas were retrospectively reviewed from January 1991 to October 2010. Read More

West Indian Med J 2010 Mar;59(2):226-9

Department of Gastrointestinal and Hepatopancreatobiliary Surgical Oncology, Tata Memorial Hospital, Mumbai, India.

A 16-year old female presented to hospital with abdominal pain. Features on computed tomography raised the possibility of biliary cystadenoma or cystadenocarcinoma. She underwent a liver resection, and histopathology confirmed a serous biliary cystadenoma. Read More

World J Gastroenterol 2011 Jan;17(3):361-5

Hepatopancreatobiliary Surgery Unit, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey.

Aim: To investigate the eligible management of the cystic neoplasms of the liver.

Methods: The charts of 9 patients who underwent surgery for intrahepatic biliary cystic liver neoplasms between 2003 and 2008 were reviewed retrospectively. Informed consent was obtained from the patients and approval was obtained from the designated review board of the institution. Read More

Ann Pathol 2010 Dec 27;30(6):448-54. Epub 2010 Nov 27.

Service d'anatomie pathologique, groupe hospitalier Paul-Brousse-Bicêtre, AP-HP, Le Kremlin-Bicetre, France.

Intrahepatic biliary cysts encompass a large lesional spectrum including hereditary diseases as polycystic liver disease or Caroli's syndrome, malformative lesions as non hereditary Caroli's disease or simple biliary cyst and true neoplastic lesions as cystadenoma or cystadenocarcinoma. The diagnostic approach of these lesions relies firstly on imaging. Nevertheless, the pathologist not exceptionally receives surgical specimens from cystic fenestration or liver specimen resection with one or several cystic lesions. Read More

World J Radiol 2009 Dec;1(1):37-44

Hui-Xiong Xu, Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, The Center of Guangdong Province for the Study of Diagnostic Ultrasound and Interventional Therapy, 58 Zhongshan Road 2, Guangzhou 510080, Guangdong Province, China.

Conventional ultrasound (US) is the first-line imaging investigation for biliary diseases. However, it is lack of the ability to depict the microcirculation of some lesions which may lead to failure in diagnosis for some biliary diseases. The use of contrast-enhanced US (CEUS) has reached the field of bile duct disease in recent years and promising results have been achieved. Read More

Surg Today 2010 Sep 26;40(9):883-9. Epub 2010 Aug 26.

Pathology Division, National Cancer Center Hospital, Tokyo, Japan.

A 52-year-old woman presented with upper abdominal pain. Abdominal ultrasonography showed a 4-cm well-defined mass containing solid and cystic components in segment IV of the liver, and contrast-enhanced T1-weighted magnetic resonance imaging revealed heterogeneous enhancement within the tumor, indicating a solid or fibrous component. There were no cystic lesions in any other organs. Read More