Cystadenomas can be found in many tissues, often with a preponderance of one of the three forms (serous, mucinous or papillary). The article below concentrates on cystadenomas of the pancreas, liver, and ovaries. However, a short literature search will discover many other tissues that harbor cystadenomas: among others, the lungs, the appendix, the mesorectum, the epididymis, the spermatic cord, the endometrium, and the parotid gland (papillary cystadenoma of the parotid gland is called Warthin’s tumor).

Most cysts observed in the pancreas are pseudocysts associated with pancreatitis. Cystadenomas are mainly of two kinds: serous and mucinous (called mucinous cystic neoplasm); both occur more frequently in women than men. Intraductal papillary mucinous tumor (IPMT) is a recently recognized category of the latter class. Whereas serous cystadenomas in the pancreas are almost always benign, mucinous cystic neoplasm (MCN) and IPMT can turn malignant - about a third of MCN cases that are resected can be associated with malignant tissue [1]. Patients may present with nausea and abdominal pain, but with the increased use and improvements in radiologic imaging technologies, many cystic lesions are discovered incidentally [2].

Cysts in the liver are quite common: they occur in 5-10% of the population; however, most of them are simple hepatic cysts. Hepatic (biliary) cystadenomas are much rarer. Biliary cystadenomas are serous and mucinous, with the overwhelming majority belonging to the latter category. Although benign, biliary cystadenomas have a strong tendency to recur, and a high potential for malignant progression. Both cystadenomas and cystadenocarcinomas grow slowly, like simple hepatic cysts. Their presentation – abdominal pain, nausea, and vomiting – is also similar. Many cysts are discovered when imaging is performed for unrelated reasons [3].

Ovaries may contain a variety of cysts, most of them formed as a result of the normal functioning of the ovaries during the menstrual cycle, such as follicular cysts and corpus luteal cysts. Abnormal growth may lead to the formation of cystadenomas, both serous and mucinous. Serous cystadenomas are the most frequently occurring epithelial ovarian tumors. Mucinous cystadenomas are usually large and multilocular and may have a tendency to grow very large. They may, occasionally, induce excessive accumulation of mucinous material in the abdominal cavity, a potentially lethal condition. Most patients with cystadenomas do not experience symptoms; thus, cysts are often discovered at routine check-ups. However, sometimes symptoms do appear: the most general being abdominal cramps and discomfort. Severe pain may accompany ovarian torsion, caused by the cysts.

• Lymphadenopathy

  It is mostly benign but has malignant potential that might present with liver metastases and lymphadenopathy. [em-consulte.com]

  Physical examination revealed an obese patient (body mass index 41 kg/m2) without appreciable lymphadenopathy. Her abdomen was obese with well-healed surgical incisions but otherwise unremarkable. [insurancenewsnet.com]

  Mediastinal lymphadenopathy. Bronchoscopy revealed distortion and partial atelectasis of the segments 1–3 of the left upper lobe and initial occlusion of segment 4 (Figure 2A). [jtd.amegroups.com]

  There was no pallor, jaundice, edema or lymphadenopathy. Cardiac and chest examinations were unremarkable. Abdomen was grossly distended by a pelvi-abdominal mass corresponding to the size of a 36 weeks pregnant uterus by palpation. [cancerjournal.net]

  No cervical lymphadenopathy was observed. Based on the history and clinical features, it was provisionally diagnosed as a benign salivary gland neoplasm. Routine blood investigations were within normal limits and there was no radiographic change. [jdrntruhs.org]

• Familial Adenomatous Polyposis

  Familial adenomatous polyposis (FAP) may be associated with some extracolonic manifestations which in this vein, it is known as Gardner's syndrome. To our knowledge, so far, there is no report of mucinous cystadenoma in association with FAP. [ncbi.nlm.nih.gov]

  […] syndrome MUTYH-associated polyposis Familial adenomatous polyposis/Gardner's syndrome Cronkhite–Canada syndrome neoplasm: Adenocarcinoma Familial adenomatous polyposis Hereditary nonpolyposis colorectal cancer Anus Squamous cell carcinoma Upper and/or [en.wikipedia.org]

  adenomatous polyposis. ( 28247059 ) Fatemi S.R....Mohsenifar Z. 2017 50 Primary retroperitoneal mucinous cystadenoma. ( 28858738 ) Nardi W.S....Quildrian S.D. 2017 [malacards.org]

• Aspiration

  Endoscopic ultrasonography and preoperative fine-needle aspiration were performed in seven patients. [nature.com]

  Marsupialization and aspiration are not indicated due to their multilocular organization. [scielo.br]

  Fine needle aspiration of the largest anechoic lesion was performed using a 22g Expect needle (Boston Scientific). One milliliter of pink tinged nonviscous fluid was aspirated. Cyst fluid analysis revealed CEA 7.1 ng/mL and amylase 633 U/L. [healio.com]

  Although uncommon, patients with ACC can undergo fine needle aspiration (FNA) of the lesion. However, the diagnosis is rarely made on cytologic examination due to sparse cellularity. [ncbi.nlm.nih.gov]

• Diarrhea

  Case Report A previously healthy 14-year-old male presented to an emergency room with 3 to 4 days of diarrhea and abdominal pain in November 2014. Abdominal X-ray demonstrated dilated loops of bowel consistent with gastroenteritis. [healio.com]

  Review of systems was pertinent for chronic diarrhea and menorrhagia. Physical examination revealed an obese patient (body mass index 41 kg/m2) without appreciable lymphadenopathy. [insurancenewsnet.com]

  She denied any nausea, vomiting, constipation, diarrhea, urinary symptoms, vaginal bleeding or discharge, or other complaints. She denied any prior history of abdominal distension or liver disease. [cureus.com]

  The patient denied any associated symptoms such as fever, chills, nausea, emesis, dyspnea, diarrhea, constipation, dysuria or vaginal bleeding but did endorse a 30-pound weight loss over 6 months. [academic.oup.com]

  She had no diarrhea and weight loss without digestive enzymes. In addition, she also maintained favorable glucose tolerance without oral hypoglycemic agents or insulin. [spandidos-publications.com]

• Chronic Diarrhea

  Review of systems was pertinent for chronic diarrhea and menorrhagia. Physical examination revealed an obese patient (body mass index 41 kg/m2) without appreciable lymphadenopathy. [insurancenewsnet.com]

• Sweating

  Digital papillary carcinoma (DPC) is a rare, underreported, and often misdiagnosed malignant tumor of the sweat glands. It is often located on the digits and toes and most commonly occurs in male individuals in their fifties to seventies. [ncbi.nlm.nih.gov]

  Adrenocortical adenoma/Adrenocortical carcinoma Hürthle cell Other/multiple Neuroendocrine tumor Carcinoid Adenoid cystic carcinoma Oncocytoma Clear-cell adenocarcinoma Apudoma Cylindroma Papillary hidradenoma Adnexal and skin appendage (8390–8429) sweat [en.wikipedia.org]

• Breast Mass

  Volume 12, Issue 2 Sonoelastographic Strain Index for Differentiation of Benign and Malignant Nonpalpable Breast Masses Nariya Cho, Woo Kyung Moon, Ha Young Kim et al. [jultrasoundmed.org]

• Adnexal Mass

  Conclusions Adnexal masses have a large variety of etiologies that can be difficult to diagnose on initial presentation. Mucinous cystadenomas are a type of benign adnexal neoplasm that can grow much larger than other masses. [cureus.com]

  Gynecol Oncol 110(1):22-31 (PMID: 18486202) [9] Tsili AC, Dalkalitsis N, Charisiadi A, Paraskevaidis E, Tsampoulas K (2010) Multidetector CT features of benign adnexal masses. [eurorad.org]

  Adnexal masses are usually asymptomatic and incidentally detected. Before extensive use of ultrasound, they are usually discovered during C-section or when they become symptomatic(3). The majority of adnexal masses originate from the ovaries. [jmrh.mums.ac.ir]

  Havrilesky LJ, Peterson BL, Dryden DK, Soper JT, Clarke-Pearson DL, Berchuck A (2003) Predictors of clinical outcomes in the laparoscopic management of adnexal masses. Obstet Gynecol 102:243–251 CrossRef PubMed Google Scholar 12. [link.springer.com]

  Ultrasound typically large cystic adnexal mass multilocular with numerous thin septations loculations may contain low-level internal echogenicity due to increased mucin content different locules may contain various degrees of echogenicity MRI Mucinous [radiopaedia.org]

• Cesarean Section

  Anahtar Kelime:Adnexal Diseases, Cesarean Section, Ovarian Neoplasms, Retrospective Studies [atif.sobiad.com]

  Objective: To examine adnexial masses which were found accidentally during cesarean section ( CIS) and evaluate these findings with literatere review. [agris.fao.org]

  She had delivered five children by cesarean section, and they were all alive and well. She lived in a rural area and was a subsistence farmer. She did not smoke and did not drink alcohol. [jmedicalcasereports.biomedcentral.com]

• Irregular Menstruation

  […] menstrual irregularity (8). [jmrh.mums.ac.ir]

Distinguishing serous and mucinous cystic lesions of the pancreas is of critical importance because mucinous cystic neoplasm has an almost 20% risk of turning malignant [1]. Serous cystadenoma of the pancreas is made up of many small cysts and usually has a grapelike or honeycomb appearance, but a small proportion of cases have oligocystic or macrocystic presentations [4], which are difficult to distinguish from mucinous cystic neoplasm. A central scar, calcification, and lack of connection with the pancreatic duct are also generally characteristic of serous cystadenoma. Mucinous cystic neoplasm has a round shape and is surrounded by ovary-like stroma. Carcinoembryonic antigen levels, which are increased inside mucinous type cystadenomas, can be determined to help distinguish mucinous cysts from macrocystic serous cystadenomas [1]. Distinction from pancreatic pseudocysts can be made clinically, based on the occurrence of pancreatitis. Adenocarcinoma is distinguished from cysts by its solid appearance. Ultrasonography and computed tomography (CT) are used to describe and characterize the cysts; however, endoscopic ultrasound and fine needle aspiration may be needed to verify the diagnosis [5].

Biliary cystadenomas are not easy to distinguish clinically from simple cysts or cystadenocarcinomas, therefore imaging and laboratory results are crucial. Both ultrasound and CT can distinguish cystadenomas from simple cysts. However, imaging may not be able to differentiate between cystadenomas and cystadenocarcinomas: both appear as an anechoic mass with echogenic internal septations. Ultrasound images do not show convincing differences between cystadenomas and cystadenocarcinomas regarding their sizes, shapes, or locations [6]. Laboratory tests show normal liver function values, although in some cases the levels of enzymes and bilirubin may be higher. Analysis of cyst fluid can show elevated tumor marker CA19-9 and tumor-associated glycoprotein 72 levels; the latter may differentiate between simple cysts and cystadenomas [7].

Ultrasonography is the initial examination that a patient suspected of having an ovarian cyst should undergo [8]. Both endovaginal and transabdominal ultrasound can be employed; sonography should yield a good morphological description. Examination by CT and magnetic resonance imaging may provide additional information. Simple ovarian cysts are rarely malignant; many patients diagnosed with ovarian cysts can be managed conservatively. In postmenopausal women with small ovarian cysts, the risk of cancer is extremely small [9]. Combined results of ultrasonography and measurements of carcinoma antigen 125 are useful for following up patients with small cysts.

• Polyps

  Juvenile polyposis syndrome (JPS) is a hereditary condition characterized by development of gastrointestinal polyps, and caused by mutations in SMAD4 or BMPR1A genes. [mayoclinic.pure.elsevier.com]

  […] cell carcinoma Adenocarcinoma Stomach Gastric carcinoma Signet ring cell carcinoma Gastric lymphoma MALT lymphoma Linitis plastica Lower Small intestine Duodenal cancer Adenocarcinoma Appendix Carcinoid Pseudomyxoma peritonei Colon/rectum colorectal polyp [en.wikipedia.org]

  Diagnostic workup included colonoscopy (seven benign polyps), Papanicolaou smear (normal), and mammogram (normal). Transvaginal ultrasound showed a large complex adnexal mass and a small right ovarian mass. [insurancenewsnet.com]

  ANUPANA VARUNADI KASHAYA HYPOTHYROIDISM,GOITRE, TUMOUR, ADENOMA, POLYPS etc VYAGHRADI KASHAYA GUGGULUTIKTAM KASHAYA DASHMOOLAKATUTRAYAM KASHYAM CH. SINUSITIS USHNA JALA PATHYA KWATHAM KHADIRA SARA KWATHA 18 20. KAISHORE GUGGULU 19 21. [slideshare.net]

• Hepatocellular Carcinoma

  The most common cystic subtype of primary liver neoplasm is hepatocellular carcinoma. Chronic hepatitis B and hepatitis C are the major risk factors for liver cirrhosis, which accounts for approximately 60-90% of all hepatocellular carcinomas. [emedicine.com]

  Upper and/or lower Gastrointestinal stromal tumor Krukenberg tumor (metastatic) Accessory Liver malignant: Hepatocellular carcinoma Fibrolamellar Hepatoblastoma benign: Hepatocellular adenoma Cavernous hemangioma hyperplasia: Focal nodular hyperplasia [en.wikipedia.org]

  High-grade dysplasia or invasive carcinoma suggest transformation to cystadenocarcinoma [23]. [hindawi.com]

  The 5-year survival of surgically resected malignant mucinous cystic tumour of the liver is 65–70%, contrasting with 40% in hepatocellular carcinoma and 22% in cholangiocarcinoma [13]. [intechopen.com]

There remains a need for education about the imaging findings for biliary cystadenoma to reduce the demonstrated delay in appropriate treatment. [insights.ovid.com]

If the cyst is small and causes no symptoms, no treatment is necessary. [cancerwall.com]

CASE REPORT A 49-year-old asymptomatic man with chronic hepatitis-C was at surveillance after 1 year treatment with interferon, when a routine ultrasonography demonstrated a pelvic mass. [scielo.br]

We report the course of 15 patients who underwent resection for biliary cystadenoma to elucidate the clinical presentation, preoperative evaluation, and surgical treatment. [jamanetwork.com]

Treatment of Benign Mucinous Cystadenoma of Ovary Treatment of benign mucinous cystadenoma of ovary mainly depends on the size of the tumor and the associated symptoms, if any. [epainassist.com]

Treatment and prognosis A mucinous cystadenoma is benign with excellent prognosis (c.f. borderline mucinous tumors of the ovary or mucinous cystadenocarcinoma of the ovary). [radiopaedia.org]

Clear cell cystadenoma: Clear cell cystadenoma is a benign cyst with an excellent prognosis. Complications Cystadenomas of the ovary are benign lesions that rarely recur after incomplete resection. [statpearls.com]

Etiology The etiology of hepatic cystadenomas is unknown. The resemblance of embryonic structures, such as the gallbladder and the biliary tree, originating from the foregut suggests that these lesions arise from ectopic remnants. [emedicine.medscape.com]

While the pelvic examination has not been shown to identify adnexal masses well, it is still recommended to assess for other etiologies [7]. [cureus.com]

Other extraovarian sites of uncertain etiology have also been reported. Very rarely these tumors are isolated to the mesentery. [insurancenewsnet.com]

A 78-year-old woman presented to the urology clinic with a large, symptomatic left-sided abdominal cyst that was believed to be renal in etiology for many years and that had been percutaneously drained 3 times previously with persistent regrowth. [ncbi.nlm.nih.gov]

Etiology Thought to largely derive from ovarian epithelial inclusions, which itself is derived from fallopian tube epithelium. Location They can be bilateral in ~15% of cases. [radiopaedia.org]

[…] the cyst lining consists of a simple epithelium, whose cells may be either:[3] be columnar and tall and contain cilia, resembling normal tubal epithelium be cuboidal and have no cilia, resembling ovarian surface epithelium Microscopical images[edit] Epidemiology [en.wikipedia.org]

Terminology Also called papillary cystadenofibroma Epidemiology Second most common benign neoplasm of epididymis after adenomatoid tumor Sporadic or familial Unilateral or bilateral (40%) Mean age 36 years Associated with von Hippel-Lindau (VHL) disease [pathologyoutlines.com]

Epidemiology. Serous cystadenomas account for ~60% of ovarian serous tumors 1. They are the commonest type of ovarian epithelial neoplasm. [najdi.si]

This article reviews pathophysiology, prevalence, CT features, mimickers and recommendations for management of pancreatic serous cystadenoma. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved. [ncbi.nlm.nih.gov]

Pathophysiology Hepatic cystadenomas appear as multilocular (rarely unilocular) cystic lesions that are surrounded by a smooth and thick fibrous capsule. [emedicine.medscape.com]

References 1 Klinge U, Prescher A, Klosterhalfen B and Schumpelick V: Development and pathophysiology of abdominal wall defects. Chirurg. 68:293–303. 1997.(In German). [spandidos-publications.com]

(I am doing a summer assignment for my Pathophysiology class and I need to write down unfamiliar terms and definitions) Any information is great. Thanks! [lookfordiagnosis.com]

Complete surgical resection of cystic masses in the mesentery is recommended to confirm the diagnosis and prevent recurrence. [insurancenewsnet.com]

Mucinous Cystadenoma Prevention and Treatment Mucinous Cystadenoma usually do not shrink by themselves they may remain as non- interfering in some cases. Smaller sized cystadenomas can be removed by laparoscopic method. [mucinous.org]

Conclusion: Proper diagnosis of masses during pregnancy can save maternal and fetal health through preventing adverse outcomes, such as abortion or preterm labor. [jmrh.mums.ac.ir]

Although the origin of ACA is still contradictory, surgery is actively advocated as the most effective method for relieving the symptoms and preventing the tumor from local extension or malignant transformation so as to obtain an optimal long-term survival [ncbi.nlm.nih.gov]

How can Benign Mucinous Cystadenoma of Ovary be Prevented? The cause of Benign Mucinous Cystadenoma of Ovary is unknown. Hence, there are no known methods to prevent the tumor occurrence. [dovemed.com]

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9. Bailey CL, Ueland FR, Land GL, et al. The malignant potential of small cystic ovarian tumors in women over 50 years of age. Gynecol Oncol. 1998 Apr;69(1):3-7.