Isolated hepatic cysts are commonly detected incidentally on abdominal ultrasonography or CT (1 Reference Isolated hepatic cysts are commonly detected incidentally on abdominal ultrasonography or CT ( 1). These cysts are usually asymptomatic and have no clinical significance. The rare congenital... read more ). These cysts are usually asymptomatic and have no clinical significance. The rare congenital polycystic liver is commonly associated with polycystic disease of the kidneys Autosomal Dominant Polycystic Kidney Disease (ADPKD) Polycystic kidney disease (PKD) is a hereditary disorder of renal cyst formation causing gradual enlargement of both kidneys, sometimes with progression to renal failure. Almost all forms are... read more and other organs. It causes progressive nodular hepatomegaly (sometimes massive) in adults. Nevertheless, hepatocellular function is remarkably well preserved, and portal hypertension Portal Hypertension Portal hypertension is elevated pressure in the portal vein. It is caused most often by cirrhosis (in North America), schistosomiasis (in endemic areas), or hepatic vascular abnormalities. Consequences... read more rarely develops. Occasionally, very large cysts cause pain or symptoms from compression of other organs. In these instances, intervention such as cyst marsupialization or drainage can be considered; however, cysts often recur. Thus, rarely, significant symptoms or quality-of-life issues warrant consideration of liver transplantation Liver Transplantation Liver transplantation is the 2nd most common type of solid organ transplantation. (See also Overview of Transplantation.) Indications for liver transplantation include Cirrhosis (70% of transplantations... read more .
Other hepatic cysts include the following:
Hydatid (echinococcal) cysts Echinococcosis Echinococcosis is infection with larvae of the tapeworm Echinococcus granulosus (cystic echinococcosis, hydatid disease) or Echinococcus multilocularis (alveolar disease). Symptoms... read more : This disease is caused by the cyst-like larvae of the Echinococcus granulosus tapeworm; humans usually become infected by fecal-oral transmission after coming in direct contact with the stool of infected animals (eg, dogs, sheep).
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 Choledocholithiasis and Cholangitis Choledocholithiasis is the presence of stones in bile ducts; the stones can form in the gallbladder or in the ducts themselves. These stones cause biliary colic, biliary obstruction, gallstone... read more , and sometimes cholangiocarcinoma Cholangiocarcinoma Primary liver cancer is usually hepatocellular carcinoma (HCC). The first manifestations of liver cancer are usually nonspecific, delaying the diagnosis. When diagnosed at advanced stages, prognosis... read more .
Cystadenoma: This rare disorder sometimes causes pain or anorexia and is evident on ultrasonography; treatment is cyst resection.
Cystadenocarcinoma Cystadenocarcinoma Primary liver cancer is usually hepatocellular carcinoma (HCC). The first manifestations of liver cancer are usually nonspecific, delaying the diagnosis. When diagnosed at advanced stages, prognosis... read more : 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.
1. Marrero JA, Ahn J, Rajender Reddy K, et al: ACG clinical guideline: The diagnosis and management of focal liver lesions. Am J Gastroenterol 109(9):1328-1347, 2014. doi: 10.1038/ajg.2014.213