Cicerone O, Basilico G, Tassi C, Antoniacomi C, Lucev F, Corallo S, Vanoli A, Maestri M. Mucinous cystic neoplasms of the liver: Literature review and case series. World J Clin Oncol 2025; 16(8): 108557 [DOI: 10.5306/wjco.v16.i8.108557]
Corresponding Author of This Article
Marcello Maestri, MD, PhD, Professor, General Surgery Unit I - Liver Service, Fondazione IRCCS Policlinico San Matteo, P.le Golgi 19, Pavia 27100, Italy. m.maestri@smatteo.pv.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ottavia Cicerone, Giorgia Basilico, Claudio Tassi, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
Caterina Antoniacomi, Department of Molecular Medicine, University of Pavia, Pavia 27100, Italy
Federica Lucev, Department of Diagnostic Imaging, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
Salvatore Corallo, Department of Oncology, Department of Internal Medicine and Medical Therapy, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia 27100, Italy
Alessandro Vanoli, Department of Molecular Medicine - Pathological Anatomy, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
Marcello Maestri, General Surgery Unit I - Liver Service, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
Author contributions: Cicerone O contributed to the concept and design of the study, data analysis and writing of the original draft; Basilico G contributed to the writing of the original draft and data curation; Tassi C contributed to data curation and reference screening; Antoniacomi C contributed to figure preparation and reference screening; Lucev F contributed to the review and editing of the manuscript and figure preparation. Corallo S contributed to the review and editing of the manuscript; Vanoli A contributed to the review and editing of the manuscript, reference screening and figure preparation; Maestri M contributed to the concept and design of the study, manuscript review and editing, supervision and project administration.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marcello Maestri, MD, PhD, Professor, General Surgery Unit I - Liver Service, Fondazione IRCCS Policlinico San Matteo, P.le Golgi 19, Pavia 27100, Italy. m.maestri@smatteo.pv.it
Received: April 17, 2025 Revised: May 18, 2025 Accepted: July 24, 2025 Published online: August 24, 2025 Processing time: 125 Days and 16.3 Hours
Abstract
Mucinous cystic neoplasms of the liver (MCN-L) are rare cystic lesions characterized by mucin-producing epithelium and ovarian-like stroma. Although they constitute fewer than 5% of hepatic cystic lesions, MCN-L poses significant diagnostic challenges due to overlapping features with other cystic lesions and their potential for malignant transformation. Early recognition and definitive surgical intervention are therefore critical to ensure optimal patient outcomes. A literature review was conducted to summarize epidemiology, clinical presentation, diagnostic modalities, and management strategies for MCN-L. Additionally, from 2019 to 2025, 9 patients with MCN-L were identified at our center. Clinical data and outcomes were retrospectively analyzed. MCN-L predominantly affects middle-aged women and presents as large, multiloculated cystic lesions without biliary communication. The revised 2010 World Health Organization classification emphasizes the presence of ovarian-like stroma for definitive diagnosis. Contrast-enhanced computed tomography or magnetic resonance imaging are often suggestive but not pathognomonic, reinforcing the need for histopathological confirmation. MCN-L remains a diagnostic and therapeutic challenge due to its resemblance to other cystic liver lesions. Complete surgical resection is the treatment of choice to prevent recurrence and malignant transformation, reinforcing the importance of early intervention. Further research is needed to improve diagnostic accuracy and refine management strategies.
Core Tip: Mucinous cystic neoplasms of the liver are rare cystic tumors with malignant potential, predominantly affecting middle-aged women. The 2010 World Health Organization classification distinguishes them from other hepatic cysts based on the presence of ovarian-like stroma. The differential diagnosis is challenging, as imaging features often overlap with other cystic liver lesions. Given the risk of recurrence and malignant transformation, complete surgical resection remains the treatment of choice. Histopathological confirmation is essential for definitive diagnosis.
