What are liver cysts?
Liver cysts are fluid-filled sacs in the liver and are present in roughly 5% of the population. Liver cysts can be present at birth or develop during your lifetime. They usually grow slowly and are often detected in adulthood.
What causes liver cysts?
Most causes of liver cysts are not known but it is thought that there may be a malformation present at birth. Some cysts can be caused by a parasite called Echinococcus which can be found in sheep in different parts of the World.
Rarely, growths in the liver can become cystic and malignant over the course of many years. Your doctor will explain to you what type of cyst you have and how best to manage it.
Diagnosis
Most liver cysts do not cause any symptoms. Sometimes, patients can feel a fullness when liver cysts grow very large, or can feel bloating or pain in the upper abdomen. A small number of patients bleed into the cyst, which causes sudden and severe right upper quadrant and shoulder pain. The bleeding stops on its own, and the pain then improves over the next several days. Most liver cysts are diagnosed with an ultrasound scan of the liver and sometimes a computed tomography (CT) scan. A simple blood test will rule out a parasite as the cause of the liver cyst.
Treatment
Simple liver cysts are always benign and the only patients who require treatment for a liver cyst are those who develop symptoms. Simply removing the fluid from the cyst with a needle is not effective because the cyst fills up again within several days. The best treatment is to remove a large portion of the cyst wall with a surgical procedure called “deroofing”. This surgical procedure can usually be done with keyhole surgery and requires only 2 or 3 small incisions and an overnight stay in the hospital. Most patients recover fully within 2 weeks. The risk of the cyst recurring is very low.
A very small number of patients (0.6% of the general population) have polycystic liver (PLD) disease, which is characterized by the liver appearing like a cluster of very large grapes. Over many years, patients with PLD may develop massive enlargement of the liver, which can result in abdominal swelling and discomfort. In extreme cases, the patient may have a very poor quality of life because of the pain and fluid. PLD does not cause liver failure. The only long-term solution for patients with severe PLD is liver transplantation.