Liver Cysts: Types, Symptoms, Causes, & Treatment

Liver cysts are non-cancerous, fluid-filled sacs that develop within the liver. Typically, these benign formations do not necessitate treatment unless they lead to symptoms, and they seldom interfere with liver function. Liver cysts are relatively rare, affecting approximately 5 percent of the population.

Some individuals may have a solitary cyst, known as a simple cyst, and may not experience any symptoms associated with it.

In contrast, others may be diagnosed with polycystic liver disease (PLD), which is marked by the presence of multiple cysts in the liver. Despite the occurrence of numerous cysts, the liver can often maintain its normal function, and this condition is not likely to impact life expectancy.

Types of Liver Cysts

Most liver cysts are benign and typically do not grow large enough to cause symptoms; however, a small fraction may develop into cancerous forms. Additionally, two specific types of cystic liver diseases may necessitate surgical intervention or other treatments:

Hydatid Disease (Echinococcal or Hydatid Cysts)

Hydatid disease is caused by parasites that are transmitted from dogs and sheep to humans, primarily through contaminated water sources. These parasites can form cysts in the liver and other organs of the body. 

If not addressed, hydatid disease can lead to symptoms such as fever, jaundice, or eosinophilia, which an elevated white blood cell count characterizes. Medical professionals typically manage these cysts with medications, including chemotherapy to eradicate the parasites, as well as surgical procedures to remove the cysts.

Polycystic Liver Disease (PLD)

Polycystic liver disease is a rare genetic condition that affects approximately 1 to 10 individuals per 100,000. Those with PLD develop clusters of benign or simple cysts in the liver, resembling large bunches of grapes. 

Research indicates that only about 20% of individuals with PLD experience noticeable symptoms, with many not showing signs until they reach adulthood. Over time, the liver may enlarge, leading to abdominal swelling and discomfort. Treatment for PLD typically involves medication and, in some cases, surgery.

Symptoms of Liver Cysts

In general, individuals with benign or malignant liver cysts often do not exhibit symptoms. However, those who do experience symptoms may notice the following:

• A dull ache in the upper right quadrant of the abdomen.
• Abdominal bloating or distension.
• Nausea.
• A diminished appetite or a sensation of fullness after eating only a small amount.
• Shortness of breath.
• The presence of noticeable lumps in the abdomen.
• Jaundice may develop if the cysts obstruct the bile ducts.
• Fever and severe abdominal pain can occur if a cyst ruptures.

Cause of Liver Cysts

Liver cysts arise from a malformation in the bile ducts, although the precise cause of this malformation remains unclear. Bile, a digestive fluid produced by the liver, flows through duct-like structures to reach the gallbladder.

Some individuals are born with liver cysts, while others may not develop them until later in life. Even congenital cysts can remain asymptomatic until symptoms manifest in adulthood.

Additionally, there is a connection between liver cysts and a parasite known as echinococcus, which is prevalent in regions inhabited by cattle and sheep. Infection can occur through the consumption of contaminated food, leading to the formation of cysts in various body parts, including the liver.

In the case of polycystic liver disease (PLD), the condition may be hereditary if there is a family history, or it may arise without any identifiable cause.

Diagnosis of Liver Cysts

In many instances, healthcare professionals identify liver cysts while conducting imaging examinations for unrelated medical issues. The imaging modalities that can reveal liver cysts include:

• Ultrasound: This technique employs high-frequency sound waves to generate real-time images and videos of internal organs and tissues.
• CT scan: This method utilizes a series of X-rays combined with computer technology to produce three-dimensional representations of soft tissues and bones.
• MRI: This non-invasive procedure uses a powerful magnet, radio waves, and computer processing to create detailed images of the body’s organs and structures.

If liver cysts are detected during these imaging assessments, the medical professional may proceed with the following actions:

• Conduct a physical examination.
• Engage in a discussion with the patient regarding their family medical history, travel experiences, and any history of chronic liver disease.
• Perform serological tests to identify specific antibodies in blood samples.
• Utilize contrast-enhanced ultrasound.

These evaluations assist physicians in diagnosing or excluding conditions such as precancerous or cancerous liver cysts, polycystic liver disease, or liver cysts resulting from parasitic infections.

Treatment for Liver Cysts

Most benign or uncomplicated liver cysts typically do not require treatment. However, healthcare professionals may opt to remove benign or uncomplicated liver cysts that exceed 4 centimeters in size.

The procedures and surgeries for the removal of large benign cysts, cysts resulting from polycystic liver disease, and precancerous or cancerous liver cysts include:

• Percutaneous aspiration: This technique involves the use of ultrasound or CT imaging to guide needles or catheters into the liver cysts for fluid drainage.
• Cyst fenestration: This surgical procedure addresses large cysts by excising the cyst wall.
• Hepatic resection: This surgery involves the removal of liver segments affected by cysts.
• Transarterial embolization (TACE): This treatment is akin to constructing a dam in a stream to halt its flow. Healthcare providers inject anti-cancer medications into an artery supplying blood to the liver, followed by the injection of a substance that blocks the artery. This creates a dam effect, allowing the anti-cancer drug to remain concentrated around the tumor.
• Surgery: This may be performed to excise either benign or malignant cysts.
• Liver transplantation: This surgical option is considered for cases of polycystic liver disease that do not respond to medications or surgical interventions aimed at cyst removal.

Note: In many cases, individuals can return to their normal activities within two weeks following the surgery. Post-operative occurrences of liver cysts are infrequent.

Bottom Line

It is never pleasant to discover an unforeseen health concern, but in the case of liver cysts, it is reassuring to note that the vast majority are benign and seldom lead to symptoms that impact one’s quality of life.

Typically, healthcare professionals prefer to monitor these cysts rather than resort to surgical removal. If you have questions or concerns regarding liver cysts, consulting with a healthcare expert can provide valuable insights and guidance on how to manage the condition effectively.