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

Objective: This study aimed to provide insight about clinical management of ciliated hepatic foregut cysts (CHFC) at a tertiary centre.

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.