To the Editor.—In the January 1971 issue of the Archives,1 we reported a case of a benign biliary cystadenoma of the liver and the common hepatic bile duct. Subsequently, the tumor became malignant and the patient died of the cancer 22 years after the original diagnosis was made. Since this change has only been reported in two previous instances, this follow-up is presented.
The patient, a 55-year-old woman when first seen in March 1968, was originally diagnosed as having a biliary cystadenoma with mesenchymal stroma (benign). She had experienced intermittent jaundice for 21 months. A liver scan at that time, using gold Au 198, showed a large, central, space-taking hepatic lesion, and laparotomy revealed a cyst, 5×7 cm in diameter, protruding from the undersurface of the liver in the region of the round ligament. An intraductal cyst in the common hepatic duct was found to connect with the