Ciliated hepatic foregut cysts: a large retrospective single-centre series

This study aimed to provide insight about clinical management of ciliated hepatic foregut cysts (CHFC) at a tertiary centre. CHFC is a rare cystic lesion of the liver with malignant potential according to previous reports. However, the current recommendation to resect all cysts in fit patients is based on limited evidence. Retrospective observational single-centre study including all patients with radiological suspicion of CHFC at Karolinska University Hospital during the years 2015–2022. Patients were characterised, mainly descriptively, regarding baseline characteristics, radiological and histopathological data, as well as data on follow-up. A total of 41 patients with suspected CHFC were identified. Of these, 23 were operated and 18 only diagnosed radiologically. Of the operated, 19 patients (83%) had a histopathological examination confirming CHCF diagnosis. No patient had dysplasia or cancer in the specimen, and no patient developed cancer during a follow-up length (from first radiology) of 82 months (3–215). CHFC can be diagnosed radiologically with acceptable accuracy. No patient in this study had malignant transformation, neither in the specimens nor during follow-up. Surgical treatment of CHCF for all patients fit for surgery should probably be challenged, but further studies supporting this change of management are needed.