Introduction:
The liver is the largest vital organ of the human body, and the main function of the liver is filtration, digestion, storage of vitamins and minerals, protein synthesis, metabolism, and detoxification. A diseased liver can cause many complications and affect a person’s health. Liver cysts are abnormal fluid-filled sacs in the liver.
What Is a Simple Liver Cyst?
Simple liver cysts are fluid-filled sacs that appear in the liver. Generally, they cause no signs or symptoms and need no treatment. Most of them are benign (non-cancerous). When they become large, which may cause pain, discomfort, and trouble to the upper right side of the abdomen. Few liver cysts are caused by congenital or inherited disorders whose cause is unknown and may require treatment.
What Are the Causes of Liver Cysts?
These cysts are uncommon and affect only five percent of the population. Most liver cysts are congenital and are present right from birth. The cause of this congenital inheritance is unknown. They may result due to malformation present at birth. Rarely, they are associated with serious underlying conditions such as:
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Echinococcus infection (a parasite infection).
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Polycystic liver disease (an inherited disorder).
Are Liver Cysts Usually Cancerous?
Rarely do these cysts become precancerous or cancerous, but most of the time, they do not cause any issues. About one to five percent of cysts are precancerous; among them, 30 % are cancerous; if the cyst is detected as cancerous, the healthcare provider gives surgical excision as the line of treatment.
What Are the Symptoms of Liver Cyst?
Either benign or cancerous cysts, most cases are asymptomatic; they do not show any symptoms, which makes them undiagnosed for years.
Until the cyst enlarges and causes a disturbance, people exhibit the following symptoms:
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Pain in the upper right abdomen.
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Abdominal pain and bloating.
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Significant enlargement of the cyst, which can be felt outside the stomach.
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Nausea and vomiting.
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Jaundice (turning of skin, mucous membranes, and whites of the eyes in yellow color), is caused due to blockage of the bile duct.
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Loss of appetite.
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Feeling short of breath.
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Acute belly pain with fever due to ruptured cysts.
Who Gets Affected by Liver Cyst?
More females are born with cysts than males. More males develop liver cysts than females. They usually affect the 30 to 70 years of age group people, and in which only 10 to 15 % of people develop symptoms.
How Large Can a Liver Cyst Grow?
A liver cyst can be the size of a pinhead, and it can grow up to 4 inches across.
Are Liver Cysts Preventable?
Almost all cysts are congenital, which means they are present right from birth, and the cause is not known. So prevention is harder, but early detection and following lifestyle modification can help.
How Is the Diagnosis Made for Liver Cyst?
These liver cysts are accidentally found on radiological imaging while diagnosing other conditions with ultrasound or computed tomography and MRI (magnetic resonance imaging).
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Ultrasound: It uses high-frequency sound waves to create real-time pictures and videos of internal organs and tissues. It can generally differentiate a simple cyst from a complicated one; a simple hepatic cyst will appear as unilocular fluid-filled spaces.
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Computed Tomography (CT) Scan: X-rays and computers to create three-dimensional images of are used soft tissues and bones.
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Magnetic Resonance Imaging (MRI): It is a painless diagnostic test using radiowaves, a large magnet, and a computer to produce clear images of body tissues.
If a healthcare provider spots a cyst during an imaging test, other diagnostic methods are used to rule out conditions like a precancerous or cancerous cyst.
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Physical Examination: Physical examination is done by palpating the area that can reveal abdominal mass or hepatomegaly.
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Serodiagnostic Test: Used to identify specific antibodies in blood samples.
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Contrast-enhanced Ultrasound: In this type of ultrasound, ultrasonic waves (high-frequency sound waves) are sent through body tissues, and their echoes are recorded and transferred into images.
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Medical History: A history of chronic liver disease, as well as details about family, medical and travel history, are taken.
What Is the Treatment for Liver Cysts?
Asymptomatic liver cysts do not require any treatment. Cysts larger than 4 cm across should be monitored, and removal of such large benign and simple cysts can be done.
Mostly polycystic liver disease, precancerous or cancerous liver cysts are responsible for a large benign cyst which has to follow certain procedures and surgical treatment like:
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Hepatic Resection: The presence of a cyst and its rupture may affect the part of the liver; in this procedure, the affected liver is removed.
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Cyst Fenestration: Treats large cysts by removing the wall surrounding the cysts.
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Percutaneous Aspiration: Using imaging techniques like ultrasound and CT, needle insertion or catheters into liver cysts is done to drain the cystic fluid.
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Transarterial Embolization (TACE): A healthcare provider injects anticancer drugs into one of the arteries that supply blood to the liver, followed by injecting a substance to block the artery. This substance acts as a dam, keeping anticancer drugs swirling around the cysts instead of floating away. This treatment works the same way as we build a dam on the stream to stop the stream's flow.
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Liver Transplantation: When the cysts or tumor does not respond to any medication or procedures, this is the option left. Liver transplantation is given.
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Surgery: To remove benign or cancerous cysts.
What Is the Prognosis of Liver Cysts?
A hepatic cyst (liver cyst) is large enough to compress the biliary tree and produce symptoms like intense pain, and there is also a possibility of rupture. This rupture of cysts may lead to many infections. A specific complication related to a certain cyst makes the prognosis poor. For example, hydatid cysts can potentially induce anaphylactic shock and sometimes be fatal.
Metastatic disease with hepatic cysts also has a poor prognosis. A mucinous cyst (a cyst that can have a malignant capacity) has a poor prognosis.
Conclusion:
Usually, simple liver cysts cause no signs or symptoms and need no treatment. If they cause pain in the abdomen and grow in size, they may lead to other complications and infections. It is difficult to distinguish between a potentially cancerous tumor and a harmless or benign one. Thus their early detection, diagnosis, and treatment are important. In rare cases, removal of the cyst is recommended. Scientists are also researching medications like Somatostatin to treat and manage liver cysts without surgery.
