Forty-nine patients with cystic disease of the liver were reviewed. Three simple liver cysts were diagnosed as cystadenocarcinoma of the liver based on the findings of X-ray-CT or ultrasonography. One cystadenocarcinoma of the liver seemed to be a simple cyst before being diagnosed by histological examination. The levels of CA19-9 and CEA in the cystic fluid of benign liver cysts were much higher than the upper normal limit for serum but within normal limits in the corresponding serum. Examination of cystic fluid of the liver does not appear to be an aid in the diagnosis since the levels of the tumor markers were high not only in malignancy but in benign diseases. In epithelial cells of the wall of benign liver cysts, there was positive immunohistochemical staining for CEA in a non-polar pattern. It seems that immunohistochemical examination is an useful means to predict the outcome of cysts and cystadenomas of the liver.
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