OJPathology  Vol.2 No.3 , July 2012
Ciliated Hepatic Foregut Cyst: 103 Cases in the World Literature
Abstract: Ciliated hepatic foregut cysts (CHFC) are rare, typically benign, lesions whose incidence has been increasing recently. Despite this increase in incidence, they remain rare and several key characteristics remain poorly understood, including the range of presentation and the risk of malignant conversion. To better understand CHFC, an extensive review of the international literature was performed. Characteristics including size, location, contents, presenting symptoms, and risk of malignancy were analyzed. In addition, an illustrative case is presented to highlight a potential pitfall in diagnosis: Although the presentation is thought to be typically painless or vaguely painful, these lesions may also present with hemorrhage and sudden severe abdominal pain. Importantly, although malignant degeneration is uncommon, analysis revealed that malignancy is significantly associated with size, which was significantly larger (median 10 cm) in malignant CHFC compared with the typical benign CHFC (3 cm) (P < 0.01). Large or symptomatic cysts, or small asymptomatic cysts that are atypical, should be resected.
Cite this paper: C. Ambe, L. Gonzalez-Cuyar, S. Farooqui, N. Hanna and S. C. Cunningham, "Ciliated Hepatic Foregut Cyst: 103 Cases in the World Literature," Open Journal of Pathology, Vol. 2 No. 3, 2012, pp. 45-49. doi: 10.4236/ojpathology.2012.23010.

[1]   N. Friederich, “Cyst emit Flimmerepithel in der Leber,” Virchows Archiv für Pathologische Anatomie und Physiologie und für Klinische Medizin, Vol. 11, 1857, pp. 446-469.

[2]   D. A. Wheeler and H. A. Edmondson, “Ciliated Hepatic Foregut Cyst,” American Journal of Surgical Pathology, Vol. 8, No. 6, 1984, pp. 467-470. doi:10.1097/00000478-198406000-00008

[3]   F. W. Zahn, “Ueber mit Flimmerepithelien Ausgekleidete Cysten Oesophagus, der Pleura und der Leber: Beitrang zur Lehre von den Angebornen Mucoicysten,” Virchows Archiv, Vol. 143, No. 1, 1896, pp. 170-187. doi:10.1007/BF01936117

[4]   Eberth, “Cyst mit Flimmerepithelial in der Leber,” Virchows Archiv, Vol. 35, No. 3, 1866, pp. 478-480. doi:10.1007/BF02199912

[5]   F. Von Reclinghausen, “Uber die Ranula, die Cyste der Bartholon’schen Druse ubd die Flimmercyste der Leber,” Virchows Archiv, Vol. 84, No. 3, 1881, pp. 425-495. doi:10.1007/BF01937669

[6]   T. A. Momin, R. Milner and J. M. Sarmiento, “Ciliated Hepatic Foregut Cyst of the Left Hepatic Vein,” Journal Gastrointestinal Surgery, Vol. 8, No. 5, 2004, pp. 601-603. doi:10.1016/j.gassur.2003.12.012

[7]   A. S. de Lajarte-Thirouard, N. Rioux-Leclercq, K. Boudjema, et al., “Squamous Cell Carcinoma Arising in a Hepatic Forgut Cyst,” Pathology—Research and Practice, Vol. 198, No. 10, 2002, pp. 697-700. doi:10.1078/0344-0338-00323

[8]   X. Zhang, Z. Wang and Y. Dong, “Squamous Cell Carcinoma Arising in a Ciliated Hepatic Foregut Cyst: Case Report and Literature Review,” Pathology—Research and Practice, Vol. 205, No. 7, 2009, pp. 498-501. doi:10.1016/j.prp.2008.12.003

[9]   D. J. Vick, Z. D. Goodman and K. G. Ishak, “Squamous Cell Carcinoma Arising in a Ciliated Hepatic Foregut Cyst,” Archives of Pathology & Laboratory Medicine, Vol. 123, No. 11, 1999, pp. 1115-1117.

[10]   A. Furlanetto and A. P. Dei Tos, “Squamous Cell Carcinoma Arising in a Ciliated Hepatic Foregut Cyst,” Virchows Archiv, Vol. 441, No. 3, 2002, pp. 296-298. doi:10.1007/s00428-002-0668-z

[11]   K. Hino, M. Simota and T. Bando, “Cystadenocarcinoma; Case Report with High CEA Level in Cyst Fluid,” Journal of Japan Surgical Association, Vol. 60, 1999, pp. 1059-1062.

[12]   N. Ben Mena, S. Zalinski, M. Svrcek, et al., “Ciliated Hepatic Foregut Cyst with Extensive Squamous Metaplasia: Report of a Case,” Virchows Archiv, Vol. 449, No. 6, 2006, pp. 730-733. doi:10.1007/s00428-006-0320-4

[13]   M. Hirata, H. Ishida, K. Konno, et al., “Ciliated Hepatic Foregut Cyst: Case Report with an Emphasis on US Findings,” Abdominal Imaging, Vol. 26, No. 6, 2001, pp. 594-596. doi:10.1007/s00261-001-0017-8

[14]   M. Kadoya, O. Matsui, Y. Nakanuma, et al., “Ciliated Hepatic Foregut Cyst: Radiologic Features,” Radiology, Vol. 175, No. 2, 1990, pp. 475-477.

[15]   E. Rodriguez, R. Soler and P. Fernandez, “MR Imagings of Ciliated Hepatic Foregut Cyst: An Unusual Cause of Fluid-Fluid Level within a Focal Hepatic Lesion (2005. 4b),” European Radiology, Vol. 15, No. 7, 2005, pp. 1499-1501. doi:10.1007/s00330-004-2573-0

[16]   A. Kimura, M. Makuuchi, K. Takayasu, et al., “Ciliated Hepatic Foregut Cyst with Solid Tumor Appearance on CT,” Journal of Computer Assisted Tomography, Vol. 14, No. 6, 1990, pp. 1016-1018. doi:10.1097/00004728-199011000-00033

[17]   F. Wu, J. McCall and I. Holdaway, “Surgical Palliation of Carcinoid Syndrome,” Australian and New Zealand Journal of Medicine, Vol. 29, No. 6, 1999, p. 840. doi:10.1111/j.1445-5994.1999.tb00801.x

[18]   M. P. Harty, A. Hebra, E. D. Ruchelli, et al., “Ciliated Hepatic Foregut Cyst Causing Portal Hypertension in an Adolescent,” American Journal of Roentgenology, Vol. 170, No. 3, 1998, pp. 688-690.

[19]   D. J. Vick, Z. D. Goodman, M. T. Deavers, et al., “Ciliated Hepatic Foregut Cyst: A Study of Six Cases and Review of the Literature,” American Journal of Surgical Pathology, Vol. 23, No. 6, 1999, pp. 671-677. doi:10.1097/00000478-199906000-00006

[20]   B. Bogner and G. Hegedus, “Ciliated Hepatic Foregut Cyst,” Pathology & Oncology Research, Vol. 8, No. 4, 2002, pp. 278-279. doi:10.1007/BF03036746

[21]   J. Carnicer, C. Duran, L. Donoso, et al., “Ciliated Hepatic Foregut Cyst,” Journal of Pediatric Gastroenterology and Nutrition, Vol. 23, No. 2, 1996, pp. 191-193. doi:10.1097/00005176-199608000-00017

[22]   K. J. Kaplan, M. Escobar, M. Alonzo, et al., “Ciliated Hepatic Foregut Cyst: Report of a Case on Fine-Needle Aspiration,” Diagnostic Cytopathology, Vol. 35, No. 4, 2007, pp. 245-249. doi:10.1002/dc.20622

[23]   S. S. Zaman, J. E. Langer and P. K. Gupta, “Ciliated Hepatic Foregut Cyst. Report of a Case with Findings on Fine Needle Aspiration,” Acta Cytologica, Vol. 39, No. 4, 1995, pp. 781-784.

[24]   A. S. Young, K. K. Nicol, S. Teich, et al., “Catheter-Based Drainage and Agitation for Definitive Cytological Diagnosis of a Ciliated Hepatic Foregut Cyst in a Child,” Pediatric and Developmental Pathology, Vol. 10, No. 2, 2007, pp. 153-156. doi:10.2350/06-06-114.1

[25]   S. Sharma, A. Corn, V. Kohli, et al., “Ciliated Hepatic Foregut Cyst: An Increasingly Diagnosed Condition,” Digestive Diseases and Sciences, Vol. 53, No. 10, 2008, pp. 2818-2821. doi:10.1007/s10620-008-0203-4

[26]   C. M. Kang, S. G. Ahn, H. K. Kim, et al., “Laparoscopic Excision of Ciliated Hepatic Foregut Cyst: A First Report in Korea,” Surgical Laparoscopy Endoscopy & Percutaneous Techniques, Vol. 16, No. 4, 2006, pp. 255-258. doi:10.1097/00129689-200608000-00013

[27]   J. D. Jakowski, J. G. Lucas, S. Seth, et al., “Ciliated Hepatic Foregut Cyst: A Rare but Increasingly Reported Liver Cyst,” Annals of Diagnostic Pathology, Vol. 8, No. 6, 2004, pp. 342-346. doi:10.1053/j.anndiagpath.2004.08.004

[28]   P. Betalli, D. Gobbi, E. Talenti, et al., “Ciliated Hepatic Foregut Cyst: From Antenatal Diagnosis to Surgery,” Pediatric Radiology, Vol. 38, No. 2, 2008, pp. 230-232. doi:10.1007/s00247-007-0648-1

[29]   M. D. Stringer, M. O. Jones, H. Woodley, et al., “Ciliated Hepatic Foregut Cyst,” Journal of Pediatric Surgery, Vol. 41, No. 6, 2006, pp. 1180-1183. doi:10.1016/j.jpedsurg.2006.01.068