Hepatic Liver Cysts

A choledochal cyst is an uncommon inborn dilation of the hepatic or bile duct of the liver, the parcel which transports bile produced by the cells to the gallbladder and duodenum. Choledochal cysts are comparatively uncommon in the United States and new Western countries. There are five types of choledochal cysts. Type 1 Cysts is making upward about half of all choledochal cysts. This character is a cystic dilation of the extrahepatic bililary duct. Type 2 Cysts is an irregular pocket or sac opening from the duct. Type 3 involves a cyst that is located within the duodenal fence.

Type 4 Cysts refers to cystic dilations of both the intrahepatic and extrahepatic biliary tracts. Choledochal cysts happen in between 1 and 100,000 and 1 in 150,000 folk in Western countries but is often more popular in Japan. Choledochal cysts do often submit during childhood but they are more usually diagnosed in maturity. Choledochal cysts are more rife in females than males, with a female-to-male ratio in the scope of 3:1 to 4:1. Choledochal cysts have some clinical expression of the disease in childhood. Approximately 67% of pediatric patients with choledochal cysts have signs or symptoms related to the cyst.

The classical symptoms of abdominal mass, pain and jaundice is seldom seen during childhood. Some children may not indicate symptoms for years. In some patients, the cyst can be felt by the physician examining the stomach. The handling of selection for choledochal cysts is comprehensive excision. Appropriate antibiotic therapy and positive maintenance should be given to patients presenting with cholangitis. Laparoscopic techniques have been successfully applied to the administration of choledochal cysts. Without operation, there is a current danger of biliary interference and incidental cholangitis, jaundice, and cirrhosis.

Another long-term worry is for cancerous degeneration. Choledochal cysts are incendiary in nature, which makes them at danger for cancer if left raw. Partial cyst resection and domestic drainage is less acceptable because of infrequent pancreatitis, cholangitis, and cholangiocarcinoma. Patients who submit with cholangitis should be treated with broad-spectrum antibiotic therapy directed against popular biliary pathogens, e. g. E. coli and Klebsiella.

Frequently Asked Questions

  1. QUESTION:
    hepatic cysts?
    i had a ct scan of my abdomen and pelvis done and the report shows that i have 2 hepatic cysts. one cyst on the left lobe of my liver and the other on the right.
    anyone know what these are and what causes them? i dont see my doctor until the 18th and i am concerned.

    • ANSWER:

  2. QUESTION:
    Hepatic Hemangiomas-Liver problems?
    I had an ultrasound which showed a cyst on my liver. I am going for a CT scan this week. My doc said that it's possible that it is a hepatic hemangioma which is always benign. In checking on different websites I found that people who have these don't have symptoms and this is usually found during a routine ultrasound. However, I have been experience intense discomfort from under my rib cage to the back and up to my neck area. Has anyone had a hemangioma with discomfort and is surgery always indicated? I know my doc will advise me upon test results; but I am rather anxious. I am a 56 yr.old healthy, non drinking woman taking estrogen replacement.

    • ANSWER:
      In my experience, hepatic hemangiomas are just an incidental finding. But the experts say: Large hepatic hemangiomas do occur, can cause symptoms -- pain, nausea, or enlargement of the liver -- and even rupture (a rare event) causing severe pain and bleeding into the abdomen that can be an emergency. http://www.medterms.com/script/main/art.asp?articlekey=9920

      Hemangiomas may cause bleeding or interfere with organ function, depending on their location. Most cavernous hemangiomas do not show symptoms. In rare cases, a cavernous hemangioma may rupture. (The only symptom may be an enlarged liver.) http://www.nlm.nih.gov/medlineplus/ency/article/000243.htm

  3. QUESTION:
    hepatic cyst on kidney?
    Hubby just found out a CT scan shows he has a hepatic cyst on his kidney, and something called "scattered inguinal lymph nodes". Can't get hold of his doctor until next Monday. He has an ultrasound scheduled in 2 weeks. We are both basket cases. Can anyone shed any light on this? All I can find is info on hepatic cysts on the liver. Are these usually signs of cancer in the kidney? He is diabetic, therefore a prime candidate for kidney problems related to diabetes. Please, someone who KNOWS what they are talking about. I'm about a millimeter away from a major panic attack and won't make it until we get the ultrasound results mid July unless I have more info on this. Please help!!!!!

    • ANSWER:

  4. QUESTION:
    Should I be concerned about probable simple liver cysts-ranging in size 2mm-2.5cm?
    Had a CT to r/o kidney stones. What was found was multiple masses, sizes 2mm-2.5cm, in the right and left hepatic lobes. The report says they appear to be benign cysts with smooth margins. I really don't like the idea of this and would hate to find out 6 mths later that it was cancer and I should have done something about it. What do you suggest? Primary doc is not concerned. Should I push for further testing? I have no pain, but every once in a while I do feel a stinging like sensation on my abdomen area.

    • ANSWER:
      Liver cysts are very common; no worries.

  5. QUESTION:
    Liver cyst that is growing at a fast rate?
    I'm a 23 year old female with no health problems besides a liver cyst. In the summer 2008, I was having pains in my stomach and my doctor did an ultrasound which found a 2.3cm in the right hepatic lobe of my liver. I seen a liver specialist who done a few more tests and said it was something that I was born with and that it was nothing to ever worry about. About 5 months ago, my right side started hurting and I went back to my family doctor, who done an ultrasound which revealed that my cyst was growing. I went back to my liver specialist, who said that my liver cyst was now on the right hepatic lobe and is 28 cm (yes, that's right 28cm!). He is doing an MRI and has done blood work. Can liver cysts grow that big? Could that be cancerous? I'm really scared.
    Thanks.

    • ANSWER:
      Cysts can be filled with fluid and expand . . so, yes it is possible for them to grow this large. Fluid filled cysts can be present at birth and as long as they don't cause any problems can be left alone. Yours, however, has changed . . and although this could be just a continuation of a fluid filled cyst it also may be a symptom of liver cancer (or other types of liver disease). You may want to ask about having a biopsy. But, as for your question . . yes, liver cancer at this point cannot be ruled out, but neither can other types of liver disease. You will need to allow your doctor to continue investigation in order to reach a 'diagnosis' . . don't let this go . . you need treatment for something this size inside your liver.

      http://emedicine.medscape.com/article/190818-overview

  6. QUESTION:
    Liver cyst that is growing fast?
    I'm a 23 year old female with no health problems besides a liver cyst. In the summer 2008, I was having pains in my stomach and my doctor did an ultrasound which found a 2.3cm in the right hepatic lobe of my liver. I seen a liver specialist who done a few more tests and said it was something that I was born with and that it was nothing to ever worry about. About 5 months ago, my right side started hurting and I went back to my family doctor, who done an ultrasound which revealed that my cyst was growing. I went back to my liver specialist, who said that my liver cyst was now on the right hepatic lobe and is 28 cm (yes, that's right 28cm!). He is doing an MRI and has done blood work. Can liver cysts grow that big? Could that be cancerous? Also, with bloodwork could they tell if I had cancer? I just had a complete WBC test done the other day that came back good. I'm really scared.
    Thanks

    • ANSWER:

  7. QUESTION:
    Liver cyst that is growing?
    A few years ago a cyst was found on my liver (a size of 2.3 cm on my left hepatic lobe) and after testing the doctors said that it was something I was born with. A few months ago I started getting abdominal pains so I went back to the doctor who sent me back to the liver specialist. The new results revealed that I have a 28cm cyst on my right hepatic lobe and that's got me scared. They are doing more testing but I won't find out anything for 6 weeks. Could a 28cm cyst really be a tumor? I'm a 23yr old female with no other health problems. I only get sharp liver pains once in a blue moon and other than that I'm fine. Also, what will they do with a cyst that large?

    Thanks.
    No, I meant 28cm. That's what the second findings concluded. I thought that was quiet large myself, but upon palpation from my doctor, he claimed he didn't feel anything. I couldn't quiet understand what he was saying (using big words). I just want to know if cysts can grow to that size, and the likelihood that it could be a tumor?

    Thank you so much.

    • ANSWER:
      You must mean a 2.8 cm cyst.
      28 cm would be huge and should cause much more than a "once in a blue moon" pain. 28 cm is 11 inches in diameter - somewhere between a volley ball and a basket ball in size. No doctor could or should miss palpating that on an examination.
      - - -
      Primary hepatic carcinoma is unlikely in a 23 year old woman.
      Whatever testing modality / imaging study you had,
      radiologists can usually discern a solid tumor mass from a cyst.
      You are paying you doctors for these answers.
      It is your right to get these answers from the doctors involved in your case.
      They have all the details of your medical history and can look at whatever scans you have had.
      We cannot see the imaging studies here.

  8. QUESTION:
    Benign or Malignant Cysts? I'm confused?
    I’m confused how the word cyst is being used when it is called malignant. Shouldn’t this be called a malignant tumour, or can cysts actually be malignant as well as benign.
    And if so, what makes them so different (beside one is more harmful than the other).
    Would they look similar in a ultrsound; or would a malignant cysts be more solid? Do they both obtain fluid/etc.?

    Last week I had an abdominal ultrasound to see if I had gallstones due to upper abdominal pain (no gallstones), but they found an 8mm hepatic cysts on the top right lope on my liver. My doctor is not concerned at all, but how does she know it’s not a malignant “cyst” without doing a biopsy?? She wants me to wait next year to have another ultrasound done to see if it’s still there or if it’s larger; she also asked me if I eat a lot of protein & cheese, why would she ask this question? I am 26 yrs old; I am healthy & active/fit. I have a good diet.

    Should I be alarmed to have to wait a year to see what happens? Or hopfully, am I worrying too much?

    Thanks for your input.

    • ANSWER:
      Cysts are not malignant.

      Ultrasound is used specifically to resolve the issue of fluid-filled (a cyst) vs solid interior (a tumor). A tumor (solid) can be either malignant (cancer) or benign. If the ultrasound is without ambiguity, they will not do a biopsy.

  9. QUESTION:
    Help with these MRCP Results please!!!?
    FINDINGS:The Extrahepatic bile ducts are mildly dilated for the patients age,with the common hepatic duct measuring up to 9mm on a series 10 image 9.

    *There is also mild prominence of the central intrahepatic duct. No intraductal filling defects are seen. The pancreatic duct is non-dilated and pancreatic duct is nondilated and the pancreatic ductal anatomy appears classic.

    *There is a duodenal diverticulum seen just anterior to the to the distal common bile duct adjacent to the pancreatic head. The gallbladder is normal in appearance with no gallbladder stones seen.

    *In the inferior right hepatic lobe is am 8mm T2 hyper intense lesion which is not fully characterized best seen on the M.R.C.P. images,

    *tiny foci of markedly bright T2 signal likely representing hepatic cysts seen in the liver dome,lateral left hepatic lobe,and in the more inferior left hepatic lobe. These measure 3 to 4 mm in diameter. No focal pancreatic lesions are seen on this non contrast study.

    *The spleen, adrenal glands, and kidneys are normal. There is a rectus diastasis and evidence of a prior mid-line surgical incision with probable mesh repair, not fully imaged.

    *Abdominal wall incisional hernia with complete rectus diastasis with significant progression in comparison with prior CT study done on 3/7/2011

    IMPRESSION:
    1) Mild biliary ductal of unclear etiology. No evidence of choledocholithiasis or

    cholecystics. Suggest correlation with liver function studies.
    2) Duodenal diverticulum seen just anterior to the to the distal common bile duct adjacent to the pancreatic head.
    3) nonspecific T2 hyperintense lesion in the inferior right hepatic lobe. The absence of any history of malignancy. this is likely to represent a hemangioma. Several tiny hepatic cysts are incidentally noted.
    4) Rectus diastasis with the probable prior mesh repair of the anterior abdominal wall. hernia also present

    • ANSWER:
      Background:
      The liver has different lobes. The main right lobe is larger
      and more to the right side of the patient. The left lobe is
      smaller in size, connected to the right lobe, and extends
      over toward the middle of the body. The other lobes are
      not mentioned here (so I will omit them).

      Cysts can be fluid filledsacs, complex(meaning they have
      something inside them more than just fluid), or [rarely] they can be
      cancerous. Cysts are just usually watched closely to see if
      they enlarge in size. If they stay the same...it is good.
      If they enlarge to a certain size where they may damage the
      liver cells around them...they may have to be removed or
      a portion removed to drain them.

      Now, about the ducts:
      The liver makes bile. This bile flows through tube like structures,
      known as ducts. The ducts inside the liver are the intrahepatic
      duct (intra means inside and hepati means the liver).
      ***Your ducts, inside the liver, are well seen, and the bile
      is flowing through them okay***
      The bile flows through these ducts to the outside of the liver
      to the gallbladder to be stored and concentrated.
      When you eat, the food moves from the mouth, to the
      esophagus, to the stomach, and then over to the first
      part of the intestines (known as the duodenum).
      Hormones are then released, and this makes the
      gallbladder contract and push the bile into the "common
      bile duct" [the main extrahepatic duct outside the liver...
      extra mean outside)
      ***The ducts outside the liver appear to be dilated.***
      The bile flows to the intestine (the first part known as
      the duodenum) to help emulsify the fats we eat so they
      can be digest and absorbed.

      Right before the common bile duct connect to the
      intestines, the duct from the pancreas connects to the
      common bile duct. It appears to be normal, not dilated.
      The pancreas is located more toward the center of
      the abdomen...behind the stomach area.

      A duodenum diverticulum is an outpouching of the
      intestines. If you think of the skin being irritated and
      a blister forms on the surface that seems to fill up...
      this is what it may look like in the intestines. However,
      the blister is more like a open place where the
      contents of the intestines can gather into.
      They see the diverticulum is located to the front of
      where the bile duct comes down to connect to the
      intestines...but, it is about even with the Pancreas
      head, which would be above it. (they are trying to
      state here, the approximate location). Your pancreas
      appears to be just fine.

      The right lobe of the liver, they see a lesion which
      they believe to be a Hemangioma. Though, they are
      not sure. An Hemangioma is a group of blood vessel
      in a cluster like form...they are usually not a cause of
      true concern..if this is what it truly is. They do see
      cysts in different areas of the liver.

      They do not see any stones (choledocholithiasis),
      growths, malformation, infections anywhere.
      However, they do see a hernia.
      And you may of had some other repair done, that they
      have taken notice of.

      Your spleen, kidneys, and adrenal glands appear to be
      fine.

      I hope this better explains things to you. Best wishes
      Only the doctor, with further testing or looking at your past
      tests done...can determine your diagnosis and "true" results.
      No one test, by itself, is 100% accurate.

  10. QUESTION:
    i have a swollen mass in my upper right abdomen ive been to a surgeon but hev hasnt told me nothing?
    he said its not a hernia,but hasnt told me what it is.i have a hepatic cyst on my liver and a gallstone.could this be the cause or something else ?has anyone else ever had this problem?someone plzzzzz help?also i have sleep apnea has anyone ever been put to sleep with sleep apnea?im only 29 plz help!!!!!!!!!!!!!!!!!

    • ANSWER:
      it could be that your gallbladder has become inflamed, is it sensitive?
      you should get to another doctor.

  11. QUESTION:
    I am 23 my recent ct scan noted a " ....small triangular area of low attenuation..." Could someone explain ...
    Ok, I am 23 with a lot of MARFAN LIKE symtoms and physical showings, however my aorta is within normal limits. I had couple ct scans done one said the following (in 10/07) note a scan in 06 came up NORMAL it was found in 07 first.....
    "THere is a hypodense (edit: i think thats what it says its blurred the report im reading) area approximately measuring 13z10mm in the lateral segment of the left love of the liver may suggest a hepatic cyst. "

    Then recently ( 04/30/08) I got another CT to check my aorta measurements, all seemed normal except again this:
    "In the medial segment of the left hepatic lobe, there
    is again noted a small triangular area of low attenuation, unchanged
    from the prior exam. It may represent an area of infarction. "

    I looked up infarction seems a heart attack stroke lack of blood supply ect can cause this.... WOW ....
    Any ideas what I have or what could of caused it or if i need to worry or do something about this?
    Please help im worried!!!!
    Thankx
    DAN

    • ANSWER:
      It is true, there is an area in the liver that may be:
      a) without blood and oxygen supply, or
      b) a cyst.

      Only way to determine what the liver has is to do a biopsy.

      On the positive side, the size taken last April 2008 remains the same as last October 2007.

      Please discuss your concerns with your doctor who has a better picture of your overall health.

  12. QUESTION:
    Please guide - liver cancer ?
    My father , 56 y, is suffering from Hep. B and is on Adefovir (Hepsera) , recently he had undergone MRI which reported as under :

    " The study shows ultered signal intensity of lvier parenchyma. Focal Lesion measuring 24x21 mm is seen in Seg. 6 of right lobe of liver appearing Hypointense in T1W & hyperintense in T2WI with tiny hyper intense focus in T1WI. The lesion shows heterogenous enhancement post contrast study with small non-enhancing areas within. The intra hepatic biliary radicals are not dialated. The prota hepatis is normal, the spleen is normal "

    The reports for other organs revealved normal except a small cyst on right kidney.

    IMP. THING 1m AGO ALSO HE HAD UNDERGONE A SONOGRAPHY WHICH REVEALED EVERYTHING IS NORMAL IN LIVER AND THE VIRAL COUNT FOR HEP. B WAS ALSO UNDER NORMAL RANGE. BUT IN 1m VIRAL COUNT HAS ALSO INCREASED TO 5.82 AND THE MRI REVEALED AS ABOVE.

    HIS CHILD PUGH SCORE IS 10.

    Pl. guide to go for transplant/rfapi and whether in 1m this can hap.

    • ANSWER:
      liver tumour or hepato-cellular carcinoma is grave thing to happen to someone. There are various modalities for treatment. including tumour resection , chemotherapy , laser ablation of tumour and percutaneous alcohol injections. your report indicates that it is still confined to one segment of liver which can be resected and you can achieve good 5 year survival rates. So u better hurry and show it to a good hepato-biliary surgeon to get desired results.

  13. QUESTION:
    I need help understanding my CT Scan results!!!!?
    Here is my 1st CT Scan performed in 2009: There is Hepatomegaly measuring 16.5 cm craniocaudally withnormal hepatic attenuation. No evidence for liver mass. There is a right upper pole renal cortica cyst measuring 2.7 cm in greatest dimension w/calcification within the posterior aspect of cyst. Note is made of duplicated right renal collecting system. Subcentimeter small bowel msentric lymph nodes are noted which are most likely benign.
    Recently I have had very painful, cronic diarrhea with some blood. I went to see a Gastroenterologist who ran multiple tests and found nothing other than slight swelling in intestines and my Sedementation rate was elevated. For a month and a half I have had A LOT of lower back pain in both left and right side. At times it is almost unbearable. I had another CT Scan done this past Wednesday with these results: 2 cm well-circumscribed predominantly fluid density cyst in the posterior mid to superior right renal pole. There is some dependant coarse calcification in its posterior wall. No other cysts seen. There are a few mildly prominent lymph nodes in the central mesentery measuring up to about 8mm in diameter.
    My questions are these: Is there anything that should be considered a concern in these results considering the fact that I have had the same cyst on my right kidney for 2 years? I have a LONG history of cancer in my family (Mother has thyroid cancer) and Lupus, should the lymph nodes or cyst be considered for a biopsy? Please help!
    Also, I dont know how to respond to answers on here if you could tell me how.. THANK YOU SO MUCH!!!

    • ANSWER:

  14. QUESTION:
    Got the results from the CT on pancreatic cancer?
    here's the results adenopathy is seen in the left supraclavicular region a 1.5x1.6cm cyst in the right thyroid. several hypodense masses as seen in the liver the largest 1.5x1.6cm in the left hepatic lobe suggestive of hepatic metastases. his pancreas mass shrunk in december 08 to 1.2 now it's 5.6cm mass in the body encasement of celiac trunk and superior mesenteric vein is enceased by the mass. the mass is seen extendedinvolving the posterior wall of the stomache and adenopathy is seen in the gastrphepatic ligament mass is also seen in the left adrenalsuggest metastases. the results mass in the body of the pancreas with encasement of spenic and superior mesenteric vein as well as celiac trunk superior artery Met astatic disease in the liver and left adrenal and post wall of the stomache. They want to start him on ctiapan chemo he doesn't want to any suggestions? if he doesnt do the chemo how much de we have together?

    • ANSWER:
      Chemo is not likely to add much time to his life and right now I think it is more about quality than quantity. You may want to start looking into hospice even if you don’t need it right now. Sometimes things change quickly and in the long run it is easier if you are prepared. At this point he probably has between 2-6 months. I remember your previous questions and it is remarkable how long he has fought this, so he may continue to surprise everyone. I am so sorry. I don’t mean to be blunt and hope this helps you in some way. May God bless you both.