KEY FACTS
Terminology
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Rare premalignant or malignant, unilocular or multilocular cystic tumor arising from biliary epithelium
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Synonyms: Hepatobiliary cystadenoma/carcinoma, biliary cystic tumor, biliary cystic neoplasm, mucinous cystic neoplasm of liver
Imaging
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Solitary, large, well-defined, multiloculated and multilobulated hepatic cyst
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Thick, irregular wall and enhancing internal septations
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May show biliary dilation from mass effect
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Biliary cystadenoma
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Thin and smooth septa
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May have fine calcifications and subtle mural nodularity (< 1 cm)
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Absence of mural nodularity makes cystadenoma more likely
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Biliary cystadenocarcinoma more commonly associated with
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Thick and irregular septa
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Mural and septal nodularity (> 1 cm) and papillary projections
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Coarse calcifications
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Hemorrhagic internal fluid
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Location
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Intrahepatic biliary ducts (83%), extrahepatic biliary ducts (13%), gallbladder (0.02%)
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Top Differential Diagnoses
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Simple/complex/complicated hepatic cyst
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Hepatic abscess
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Echinococcal (hydatid) cyst
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Cystic metastases
Clinical Issues
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Primarily occurs in middle-aged white women
with lobulated contour and multiple, irregular, vascularized septations 
.
. Most biliary cystadenomas are seen in middle-aged women.
and layering debris 
.
