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.

• Pain

  Symptoms include abdominal pain, distension, pelvic mass, and, in rare cases, hormonal manifestations due to stromal luteinization. [webpathology.com]

  We report a 58-year-old man who presented with lower abdominal pain. Ultrasound and CT imaging defined a large lobulated cystic mass superior to the urinary bladder. [ncbi.nlm.nih.gov]

  Case presentation A 27-year-old female patient from rural areas referred to our clinic due to a three-month dull abdominal pain, followed by gastrointestinal upset. [jmrh.mums.ac.ir]

  Acute abdomen pain due to intestinal obstruction caused by PRM cystadenoma has also been reported[5]. [wjgnet.com]

• Asymptomatic

  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]

  In conclusion, this case proves that huge asymptomatic Brenner's tumors still occur in patients. Proper histological examination of the surgically removed specimens is essential to confirm the diagnosis. [cancerjournal.net]

  To our knowledge, we present the first detailed case report of FNA of ACC in a 22-year-old asymptomatic female. [ncbi.nlm.nih.gov]

  Clinical presentation Usually cysts are asymptomatic and they are found incidentally doing routine gynecological examination. [cancerwall.com]

• Pathologist

  Pathologists and dermatopathologists should be aware that a histopathologic diagnosis of AH or cystadenoma on the fingers and toes should be established with caution, because probably those lesions represent the superficial and cystic component of an [ncbi.nlm.nih.gov]

  Histopathology [ edit ] Serous cystadenomas are diagnosed by histomorphologic examination, by pathologists. Grossly, they are, usually, unilocular cysts that contain clear, straw-coloured fluid. [en.wikipedia.org]

  International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists Aug 23, 2018 Abstract Brenner tumors are uncommon ovarian neoplasms which occasionally occur in combination with a mucinous [meta.org]

  Examination of the biopsy under a microscope by a pathologist is considered to be the gold standard in arriving at a conclusive diagnosis. [dovemed.com]

• Surgical Procedure

  Surgical procedures included simple appendectomy (1/24, 4.2 %), partial cecectomy (15/24, 62.5 %), and ileocecal resection (8/24, 33.3 %). Mean operative time was 108.5 min (range 40-205 min). [ncbi.nlm.nih.gov]

  Surgical intervention may be considered when a cystadenoma of the seminal vesicle is diagnosed and symptoms or tumor growth occurs transvesical removal of seminal vesicle mass is an effective surgical procedure for seminal vesicle disease. [panafrican-med-journal.com]

  An accurate diagnosis is essential for the selection of the appropriate surgical procedure. [spandidos-publications.com]

  Surgical procedures performed were as follows: nonanatomical liver resection (52%), left hemihepatectomy (34%), right hemihepatectomy (10%), and left lateral segmentectomy (3%). [hindawi.com]

  Cancer of pancreas, serous cystadenoma, surgical procedures, operative. [actagastro.org]

• Severe Pain

  Severe pain may accompany ovarian torsion, caused by the cysts. 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. [symptoma.com]

  • Four days before, he suffered a severe pain and the swelling was increasing in size. [asnanak.net]

  She had no previous history of abdominal pains or jaundice. She had no history of hospitalization for severe pain or acute pancreatitis. She had a firm, non-tender central abdominal mass occupying the upper 1/3 of the abdomen. [gs.amegroups.com]

• Dyspnea

  The pain started 5 days earlier and worsened with sitting and walking; she also experienced increasing dyspnea. She had noticed increasing abdominal girth about 5 months earlier. Since then, she had gained 5 to 10 lb, despite dieting. [patientcareonline.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]

  On arrival at our hospital the patient showed slight dyspnea, normal arterial pressure and pulse. [clinmedjournals.org]

  Case presentation A 58-year old female with a history of recurrent airway infections was admitted to the hospital with cough, dyspnea and pain in the left lower side of the chest. Serum C-reactive protein (CRP) levels were only moderately elevated. [jtd.amegroups.com]

• Abdominal Pain

  Symptoms include abdominal pain, distension, pelvic mass, and, in rare cases, hormonal manifestations due to stromal luteinization. [webpathology.com]

  We report a 58-year-old man who presented with lower abdominal pain. Ultrasound and CT imaging defined a large lobulated cystic mass superior to the urinary bladder. [ncbi.nlm.nih.gov]

  Experiences and lessons This report describes a female patient with abdominal pain and a palpable mass in the left lower abdominal quadrant. [wjgnet.com]

  Their patient had a one-year history of gradual abdominal swelling, which was accompanied by constipation and vague abdominal pain. By successful laparotomy, a 35×25×25 cm mass had been removed (5). [jmrh.mums.ac.ir]

• Cheilitis

  In contrast, cheilitis glandularis represents an inflammatory alteration of the lower lip of unknown etiology, which might be diagnosed as a neoplasm. [scielo.br]

  Cheilitis glandularis: An unusual histopathologic presentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 95: 312-7. [revistas.unc.edu.ar]

• 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]

• Pelvic Pain

  Symptoms include abdominal discomfort and chronic pelvic pain. Rare tumors may undergo torsion and cause acute abdominal pain. Grossly, they consist of thin-walled unilocular cyst usually filled with clear serous fluid. [webpathology.com]

  Medical history was non-contributory except for mild intermittent pelvic pain. Cardiologic and neurological evaluation found no cause of syncope. Abdominal ultrasound revealed a right ovarian tumour that was laparoscopically removed. [ncbi.nlm.nih.gov]

  These tumors usually develop in the third to fifth decades of life and typically cause vague symptoms, such as increasing abdominal girth, abdominal or pelvic pain, emesis, fatigue, indigestion, constipation, and urinary incontinence.2,3 Because this [patientcareonline.com]

  pain Bloating Discomfort Evaluation Serum CA-125 assay: Serum CA-125 assay is a useful tool that helps to distinguish between benign and malignant ovarian masses. [statpearls.com]

• Confusion

  The Liver[edit] A rare neoplasm, 95% cases occur in women, especially at the mean age of 45.[8] Biliary cystadenoma and cystadenocarcinoma constitute less than 5% of intrahepatic cysts originating from the bile duct.[8] Cystadenomas in liver are often confused [en.wikipedia.org]

  Adenocarcinoma is most commonly solid and, therefore, infrequently confused with cystic neoplasms. The other entities can have imaging features that are highly suggestive of one entity rather than another. [emedicine.com]

  I feel like I am on the verge of a breakdown and I don't know what to do anymore ... is it normal to feel this confused and helpless I have such a supportive family but I feel like they just don't get what I am going through mentally in the same way it [cancerresearchuk.org]

  There are several reported cases where clear cell papillary cystadenoma of the epididymis was confused with metastatic renal cell carcinoma. 5 The differential diagnosis is further complicated by the fact that both renal cell carcinoma and papillary cystadenoma [path.upmc.edu]

• Irritability

  On physical examination, signs of peritoneal irritation were found. The patient was operated, finding an appendiceal tumor that was coiled up in the mesentery with large bowel gangrene. [scielo.conicyt.cl]

  One patient was incidentally found to have a cystic lesion in the liver on ultrasound scan performed for irritable bowel syndrome like symptoms. On preoperative imaging, single cyst was seen in majority of the patients (76%). [hindawi.com]

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.

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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3. 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.
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7. 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.
8. Osmers R. Sonographic evaluation of ovarian masses and its therapeutical implications. Ultrasound Obstet Gynecol. 1996 Oct;8(4):217-222.
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.