Biliary Duct Hamartomas: A Systematic Review

Abstract

Biliary duct hamartomas are benign intrahepatic bile duct lesions. Despite being primarily incidental findings on imaging, these lesions can provide a diagnostic conundrum due to their shared characteristics with malignant tumors. The goal of this systematic review is to offer a thorough clinical profile of biliary duct hamartomas. There were 139 cases of biliary duct hamartomas identified in a structured systematic review of the literature. Patient demographics, clinical presentation, significant laboratory and imaging data, diagnostic modalities, treatment choices, and outcomes were all studied and reported. Biliary duct hamartomas present with mild symptoms and laboratory abnormalities, and while being visible on imaging, the results are non-specific and may require biopsy in case of red flag signs such as weight loss and a progressive increase in the size of the lesion. Furthermore, there are currently no published guidelines for the treatment of biliary duct hamartomas, and many people have had surgery despite the clinically benign nature of these abnormalities. As per the findings of the study, individuals who exhibit signs of malignancy should be investigated further. Eyeballing for red flag symptoms, followed by a specialized imaging scan and invasive treatment, is the three-step approach to biliary duct hamartomas. Since our recommendations include a shift in strategy and do not contradict existing rules, there are likely to be few roadblocks to improvement; the key barriers being technological equipment and image quality. In this study, we intended to pave the way for future research in the field. In our opinion, the next decade will bring a better understanding of the characteristics of biliary hamartomas, disease symptoms, and better recognition of any suspicious features. These indications will aid in reducing the number of unneeded surgical or invasive operations. Finally, the findings of these future studies will allow the medical community to improve and provide the best care possible.

Multiple biliary duct hamartomas in a cat resulting in a hepatic mass: A case report

“…Several studies have found that the lesions, specifically the septae, become more distinct, rather than contrast enhancing on CT (Eisenberg et al, 1986;Ryu et al, 2010;Sheikh et al, 2022). This is a perplexing characteristic that could result in a malignancy diagnosis in humans (Sheikh et al, 2022). In the present case report, the differential diagnoses changed depending on the imaging modality used.…”

“…Rarely, cases can present with nonspecific clinical signs, such as pain on abdominal palpation, jaundice or fever. Although the majority of patients have normal laboratory results, some may develop minor haematologic abnormalities, most frequently increased liver enzymes (Carmona et al, 2022;Lanser & Puckett, 2023;Priadko et al, 2022;Sheikh et al, 2022).…”

“…These complexes can be diagnosed by imaging (either AUS and/or CT), as single or multiple small cyst-like lesions < 1.5 cm in diameter that lack communication with the biliary tree (Lanser & Puckett, 2023;Sinakos et al, 2011;Song et al, 2008). According to a systematic review of 139 human cases, ultrasonography for BDHs is typically nonspecific, and lesions on CT scan are predominantly hypoattenuating (Sheikh et al, 2022;Torbenson, 2018). Several studies have found that the lesions, specifically the septae, become more distinct, rather than contrast enhancing on CT (Eisenberg et al, 1986;Ryu et al, 2010;Sheikh et al, 2022).…”

“…According to a systematic review of 139 human cases, ultrasonography for BDHs is typically nonspecific, and lesions on CT scan are predominantly hypoattenuating (Sheikh et al, 2022;Torbenson, 2018). Several studies have found that the lesions, specifically the septae, become more distinct, rather than contrast enhancing on CT (Eisenberg et al, 1986;Ryu et al, 2010;Sheikh et al, 2022). This is a perplexing characteristic that could result in a malignancy diagnosis in humans (Sheikh et al, 2022).…”

“…Hamartomas are rare tumours of focal disorganised mature mesenchymal or epithelial tissue found in their normal anatomic location (Sheikh et al, 2022). These tumours occur in both animals and humans.…”