Cistoadenoma biliare gigante del fegato. Presentazione di un caso clinico

Cystadenomas of the liver are rare (less than 5% of the cystic lesions of the liver) benign neoplasms, but potentially malignant, uni or more frequently multilocular; benign cystadenomas more commonly affect females (older than 40 years of age) than males, with a reported femaleto-male ratio of 4:1; instead malignant cystadenocarcinomas display a more equal male-to-female ratio. They usually arise in the liver (80-85%), less frequently in the extrahepatic bile ducts and rarely in the gallbladder. The patients may be asymptomatic with their tumors discovered incidentally during radiographic evaluation or surgical exploration for other clinical indications. However, they often have vague abdominal complaints, abdominal palpable mass, abdominal distension, jaundice, anorexia, nausea or vomiting. There are two distinct classes of liver cystadenomas based on the presence or absence of “mesenchymal stroma”. All cases with mesenchymal stroma occur in women; there is also a correlation between mesenchymal stroma and the risk of cystadenocarcinoma. For his potential malignancy and for the high rate of recurrence in case of incomplete resection or alternative treatment to the surgery, the therapy of choice is complete resection also for the impossible pre-operating histological differentiation between the benign from malignant forms. We report a case of male giant intrahepatic biliary cystadenoma, rather unusual because occurred in a old man