Biliary cystadenoma in young females with favorable surgical outcomes: A case series

Abstract

Background: Biliary cystadenoma is a rare cystic neoplasm of the liver with potential for malignant transformation, often presenting with nonspecific clinical features. Preoperative diagnosis can be challenging due to overlapping imaging characteristics with other cystic hepatic lesions and variable tumor marker levels. We present a case series of two female patients with biliary cystadenoma who exhibited distinct clinical and radiological presentations. The first case involved a young female presenting with acute symptoms, obstructive jaundice, and markedly elevated CA 19-9 levels, mimicking a malignant lesion. Imaging revealed a large multiloculated cystic lesion with biliary compression, and intraoperative findings confirmed biliary communication, making surgical excision technically demanding. The second case presented with a more indolent course, mild symptoms, and typical imaging features without biliary involvement, allowing for straightforward surgical management. Both patients underwent complete surgical enucleation, and histopathological examination confirmed biliary cystadenoma without evidence of malignancy. The postoperative course was uneventful in both cases, with favorable outcomes. This case series highlights the varied clinical spectrum of biliary cystadenoma, the limitations of tumor markers such as CA 19-9 in differentiating benign from malignant lesions, and the importance of complete surgical enucleation for optimal outcomes.