Liver Cysts - Causes and Symptoms

Definition

Liver cysts are liquid or semi-liquid collections that form inside the hepatic parenchyma; these lesions can be single or multiple, simple (roundish and well defined) or complex (as happens with parasitic cysts).

Simple hepatic cysts

Among the hepatic cysts, the simple forms are those found most commonly; in general, these benign lesions are filled with liquid, without septa in cross section and asymptomatic. The underlying cause of their onset is not known, but it is believed that simple liver cysts may result from congenital anomalies occurring during the development of the bile duct.

Generally, simple liver cysts have no clinical significance, so it is not necessary to take any therapeutic measures. Only in the case in which these formations are particularly voluminous or symptomatic, will it be appropriate to monitor them over time or provide for treatment by, for example, percutaneous aspiration of the liquid contained in them, fenestration, pericistectomy or liver resection.

Hydatid cysts (hepatic echinococcosis)

In some cases, hepatic cysts represent a stage in the life cycle of some parasites, such as echinococcus. The diagnosis of hydatid cysts must be excluded with serological investigations and cystic fluid analysis.

Polycystic hepatic disease

Polycystic liver disease is a condition characterized by the presence of many cysts (usually more than 20), of different sizes, in the context of the organ.

This condition is determined by mutations of four genes and is sometimes associated with congenital polycystic kidney disease. In this context, cysts can be asymptomatic or cause pain, nausea, vomiting, abdominal swelling and progressive nodular hepatomegaly.

Surgical treatment should only be considered when severe and persistent manifestations can significantly affect quality of life.

Caroli disease

Another congenital pathological condition in which multiple cystic lesions can be found inside the liver is Caroli's disease. This condition is characterized by the presence of saccular or fusiform dilatations of the intra-hepatic bile ducts.

Patients with Caroli's disease present multiple episodes of cholangitis (ie biliary tract infections with jaundice, fever and pain), liver abscesses and intrahepatic calculi.

Chronic inflammation increases the risk of developing a cholangiocarcinoma. If limited and localized, Caroli's disease can be treated with surgical resection, while in diffuse forms, liver transplantation is the only definitive solution.