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Hepatic Cysts

By Steven K. Herrine, MD, Professor of Medicine, Division of Gastroenterology and Hepatology, and Vice Dean for Academic Affairs, Sidney Kimmel Medical College at Thomas Jefferson University

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Isolated cysts are commonly detected incidentally on abdominal ultrasonography or CT (1). These cysts are usually asymptomatic and have no clinical significance. The rare congenital polycystic liver is commonly associated with polycystic disease of the kidneys and other organs. It causes progressive nodular hepatomegaly (sometimes massive) in adults. Nevertheless, hepatocellular function is remarkably well preserved, and portal hypertension rarely develops.

Other hepatic cysts include the following:

  • Hydatid (echinococcal) cysts (see Echinococcosis)

  • Caroli disease: This rare, autosomal recessive disorder is characterized by segmental cystic dilation of intrahepatic bile ducts; it often becomes symptomatic in adulthood, with stone formation, cholangitis, and sometimes cholangiocarcinoma.

  • Cystadenoma: This rare disorder sometimes causes pain or anorexia and is evident on ultrasonography; treatment is cyst resection.

  • Cystadenocarcinoma: This rare disorder is probably secondary to malignant transformation of a cystadenoma and is often multilobular; treatment is liver resection.

  • Other true cystic tumors: These tumors are rare.