A cystadenoma is a benign growth of glandular tissue that forms a cyst and is filled with secretions. Although cystadenomas are benign, they may cause problems by compressing neighboring tissues. The three major forms are serous, mucinous and papillary cystadenomas. The different forms have varying tendencies for malignant transformation.
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 . 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 .
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 .
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.
Jaw & Teeth
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 . 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 , 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 . 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 .
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 . 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 .
Ultrasonography is the initial examination that a patient suspected of having an ovarian cyst should undergo . 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 . Combined results of ultrasonography and measurements of carcinoma antigen 125 are useful for following up patients with small cysts.
Other ECG Findings
- Ischemic Changes
No ischemic changes occurred in the bowel. The presence of several well-developed collateral vessels was shown by 3-dimensional computed tomography examination. The patient had an uneventful postoperative period and was discharged. [ncbi.nlm.nih.gov]
changes and of future malignancy are low. 7, 8 According to a study by Papic et al, 9 predictors for ovarian malignancy in children include tumor size 10 cm (although some use 7.5 cm and 8 cm as a cutoff), tumor with primarily solid components, and elevated [pediatrics.aappublications.org]
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]
CONCLUSION: The only possible treatment of cystadenomas is their radical surgical removal. Any other incomplete surgical treatment is insufficient and associated with a high risk of malignant transformation. [ncbi.nlm.nih.gov]
There remains a need for education about the imaging findings for biliary cystadenoma to reduce the demonstrated delay in appropriate treatment. [insights.ovid.com]
Early diagnosis with close monitoring and treatment of the tumor is important. [dovemed.com]
Long-term prognosis is good in the case of a benign tumor. [ncbi.nlm.nih.gov]
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]
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]
While the pelvic examination has not been shown to identify adnexal masses well, it is still recommended to assess for other etiologies . [cureus.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]
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: be columnar and tall and contain cilia, resembling normal tubal epithelium be cuboidal and have no cilia, resembling ovarian surface epithelium Microscopical images 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]
Their histological, epidemiological and semiological characteristics are now better known. However, their natural history remains poorly understood affecting therapeutic management as well. [internationalpancreatology.org]
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]
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]
Pathophysiology Hepatic cystadenomas appear as multilocular (rarely unilocular) cystic lesions that are surrounded by a smooth and thick fibrous capsule. [emedicine.medscape.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]
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]
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]
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]
Complete surgical resection of cystic masses in the mesentery is recommended to confirm the diagnosis and prevent recurrence. [insurancenewsnet.com]
- Farrell JJ. Prevalence, Diagnosis and Management of Pancreatic Cystic Neoplasms: Current Status and Future Directions. Gut Liver. 2015 Sep 23;9(5):571-589.
- Kadiyala V, Lee LS. Endosonography in the diagnosis and management of pancreatic cysts. World J Gastrointest Endosc. 2015 Mar 16;7(3):213-223.
- Nakagawa M, Matsuda M, Masaji H, Goro W. Successful preoperative diagnosis of biliary cystadenoma with mesenchymal stroma and its characteristic imaging features: report of two cases. Turk J Gastroenterol. 2011;22:631–635.
- Tseng JF, Warshaw AL, Sahani DV, Lauwers GY, Rattner DW, Fernandez-del Castillo C. Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg. 2005 Sep;242(3):413-419.
- Gerke H, Silva R, Jensen CS. Hypervascular pancreatic tumor diagnosed as a serous cystadenoma by EUS-guided Trucut biopsy. Gastrointest Endosc. 2006;64:273-274.
- Xu HX, Lu MD, Liu LN. Imaging features of intrahepatic biliary cystadenoma and cystadenocarcinoma on B-mode and contrast-enhanced ultrasound. Ultraschall Med. 2012 Dec; 33 (7): E241-249.
- Fuks D, Voitot H, Paradis V, et al. Intracystic concentrations of tumour markers for the diagnosis of cystic liver lesions. Br J Surg. 2014 Mar;101(4):408-416.
- Osmers R. Sonographic evaluation of ovarian masses and its therapeutical implications. Ultrasound Obstet Gynecol. 1996 Oct;8(4):217-222.
- 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.