Are Liver Cysts Serious?
Liver cysts are also known as hepatic cysts. They are rare, benign fluid filled cavities that are often diagnosed inadvertently at the time of abdominal imaging. They are found in about 5% of the total population and typically do not affect the functioning of liver. Hence, it is simple and easy to answer the question whether liver cysts are serious health issue or not and the answer is no they are not. Liver cysts as mentioned above are rare and benign and do not interfere with normal liver functioning and in most of the cases are asymptomatic. They can go unnoticed for life without any signs and symptoms with no change in quality of life of an individual, so they are not a serious issue.
Different Types of Liver Cysts
The Different Types Of Liver Cysts Are:
Simple Cysts: They are known as simple cyst as when found, they present with a single liver cyst. They are the most common type of cysts found in the liver and thought to be a result of bile duct malformation and what leads to the malformation of the bile duct are yet unknown. They are present from birth and the abnormality in the bile duct occurs at the time of embryo development. Bile that aids in food digestion is made by the liver and stored in gall bladder. Simple cysts contain bile like fluid and are covered with epithelial cell lining. They typically measure less than 3 cm in maximum diameter.
Cystic Echinococcosis: It is a parasitic infection causes by tapeworm that is transmitted from infected dogs, sheep and cattle to humans through their contaminated feces. In humans, the larval stage of Echinococcus granulosus and Echinococcus multilocularis are responsible for the production of liver cysts. In general, this infection is not common in the US, but other developing countries.
Polycystic Liver Disease: Liver consists of more than 20 cysts in this rare genetic disorder. It consists of two types: autosomal dominant polycystic liver disease and autosomal dominant polycystic kidney disease, out of which autosomal dominant polycystic kidney disease is more common than the other is.
Cystadenoma and Cystadenocarcinoma: These represent benign and malignant forms of cystic tumors. Cystadenomas are similar to simple cysts as they both are derived from epithelial lining, so most of the times they are misdiagnosed as simple cysts that results in inadequate management and transforming to its malignant form cystadenocarcinoma, which are slow growing in nature with a mean diameter of 12 cm.
Symptoms of Liver Cysts
In general, most of the liver cysts are asymptomatic, as they do not hinder the function of liver. They become symptomatic only when they enlarge and grow in size, which may lead to symptoms of abdominal distention and discomfort, postprandial fullness, back discomfort and shortness of breath. If there is bleeding due to cyst, then it may lead to sudden and sharp pain in the liver. Echinococcosis can lead to fever, severe skin rash and bloody phlegm. Echinococcus multilocularis (alveolar echinococcosis) may cause symptoms resembling liver cirrhosis or liver cancer.
Diagnosis and Treatment of Liver Cysts
Liver cysts are usually diagnosed through imaging with the help of ultrasound, CT scan and MRI. Echinococcosis is diagnosed by blood test to detect antibodies against Echinococcus.
Echinococcosis is treated with antiparasites such as albendazole or mebendazole and the cysts need to be surgically removed.
Generally, asymptomatic cysts do not require any intervention; cysts are intervened only if they are large and symptomatic and are impairing the quality of life. Cysts can be managed either with cystic fluid aspiration, laparoscopic/open fenestration (creation of surgical window in the cyst along with fluid drainage). Both these techniques can lead to recurrence of cyst, but most of the patients have symptomatic relief. If the above management is not successful, especially in cases of polycystic liver disease, then treatment can also include resection of a segment of liver or liver transplantation.