From the Guidelines
Surgical resection is the primary treatment for cystadenoma, as it offers the best chance of complete removal of the tumor and minimizing the risk of recurrence 1.
Key Considerations
- Complete surgical removal of cystadenomas has been shown to yield good long-term outcomes with a very low recurrence rate 1.
- The presence of malignancy is a significant factor associated with poorer outcomes, highlighting the importance of early and accurate diagnosis 1.
- Fenestration is not recommended as it is associated with higher rates of tumor recurrence 1.
Treatment Options
- Major liver resections, including extended hemihepatectomy, may be necessary to allow for complete removal of the cyst 1.
- Enucleation with free margins is also considered an option, particularly for centrally located tumors 1.
- More extensive procedures, such as total vascular exclusion and liver transplantation, may be considered in complex cases 1.
Post-Operative Care
- Post-operative follow-up is essential to monitor for recurrence, with imaging studies such as ultrasound or computed tomography (CT) scans recommended at regular intervals 1.
- The current literature provides compelling evidence to recommend complete surgical resection of cystadenomas, due to the low prevalence of these tumors and the difficulty in establishing a reliable diagnosis on imaging 1.
From the Research
Treatment Options for Cystadenoma
- Surgical resection is the most effective treatment for cystadenoma, as it allows for complete removal of the tumor and reduces the risk of recurrence and malignant transformation 2, 3, 4, 5
- The type of surgical procedure used depends on the location and size of the tumor, as well as the patient's overall health 2, 4, 5
- For serous cystadenomas, a complete cyst excision can be performed, with an operative mortality rate of 2% 2
- For mucinous cystic neoplasms, resection is recommended due to the risk of malignant progression 2
- In some cases, a watchful waiting approach may be considered for asymptomatic serous cystadenomas, but this requires close monitoring and regular follow-up 2, 6
Importance of Accurate Diagnosis
- Accurate preoperative diagnosis of tumor type is crucial for determining the best course of treatment 2
- Imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging can be helpful in diagnosing cystadenoma, but histological examination is necessary for definitive diagnosis 2, 4
- Invasive investigations such as endosonography and diagnostic aspiration of cystic fluid may be useful in some cases, but their assessment is limited to small series 2
Recurrence and Malignant Transformation
- Cystadenoma has a high risk of recurrence after conservative treatment, and there is also a potential risk of malignant transformation 4, 5
- Complete resection of the tumor is the best way to prevent recurrence and reduce the risk of malignant transformation 2, 4, 5
- Regular follow-up and monitoring are necessary to detect any signs of recurrence or malignant transformation 2, 6, 5