Biliary cystadenoma and cystadenocarcinoma laboratory findings

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

Laboratory findings consistent with the diagnosis of biliary cystadenoma include elevation of serum alkaline phosphatase, serum bilirubin, and CA 19-9 in cystic fluid. Some patients with biliary cystadenoma may have leukocytosis with left shift, which is usually suggestive of superinfection of the tumor.^[1]

• Elevation of alkaline phosphatase and bilirubin may be present.
• CA 19-9 may be elevated in the serum and in the cystic fluid, while CEA and α-fetoprotein levels are usually normal.
• Laboratory tests may show leukocytosis with a left shift in case of superinfection of the tumor.^[1]

Cystic fluid analysis during laparoscopy is advocated in the surgical treatment of hepatic cysts. In fact, the presence of elevated intracystic levels of CA 19-9 can support the diagnosis of cystadenoma. Therefore, it was concluded that CA 19-9 levels can differentiate between simple hepatic cyst and cystadenoma, and that cyst fluid analysis should always be performed, allowing to spare those patients with asymptomatic simple cyst from aggressive surgical treatment.^[1]

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