Biliary cystadenoma and cystadenocarcinoma history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]

Symptoms of biliary cystadenoma include abdominal pain in right upper quadrant, abdominal distension, abdominal mass, nausea, and vomiting.^[1]

The clinical presentation of biliary cystadenoma is variable, depending on the size and location of the tumor. Pain is considered the leading symptom in most series, being present in about 80% of cases.

• Typically, the patient is a middle-aged woman presenting with abdominal pain and/or discomfort, with distension and a palpable mass.^[2]
• Acute presentation is often pain due to intracystic hemorrhage or rupture of the cystand fever secondary to infection of the cyst.
• Rare presentations include vomiting, dyspepsia, anorexia, and weight loss.^[2]
• In other cases, non specific signs and symptoms may develop, due to compression of neighboring structures, such as jaundice, signs of cholangitis, cyst infection, and hemorrhage.
• Jaundice is either due to an extrinsic compression of the bile duct, biliary obstruction by an intraluminal tumoural mass, or accretion of mucus secretion from a communicating biliary cystadenoma.
• Ascites may be present secondary to compression of the inferior vena cava or the hepatic veins.
• Cystadenomas are known to increase in size during pregnancy and following oral contraceptives suggesting hormonal dependency.
• Compression of the vena cava or the portal vein may also cause lower limb edema or signs of portal hypertension such as splenomegaly.^[3]

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