Liver Cyst

What is a liver cyst?

Liver cysts, also known as hepatic cysts are thin-walled pouch filled with fluid, air or semi-solid substance that occurs in the liver. It is usually asymptomatic or discovered while computed tomography or magnetic resonance imaging (MRI). One or two small liver cysts do not cause a problem and can be neglected, but if there are numerous cysts, then medical treatment is required.

Pathophysiology & Etiology

Simple Cyst

The origin of simple cyst is still unknown, but it is assumed to be congenital. They are present from birth and are formed due to abnormal bile duct cells during embryo’s growth. These cysts are lined by biliary-type epithelium which results in progressive dilation of biliary microhamartomas. Because of the presence of bile in these cysts, the microhamartomas fail to develop a connection with the biliary tree. Needle aspiration is not a cure for this type of cyst and recurrence can be expected.

Polycystic Liver Disease (PCLD or PLD)

A polycystic liver disease is a rare genetic condition which is present from birth and looks like a cluster of massive grapes. They grow independently in different parts of the liver and if increased in size can cause significant discomfort and health issues. Only surgery can help in recovery.

People who are affected by PLD are also likely to have polycystic kidney disease (PKD). It is a cyst in the kidney that causes kidney failure and high blood pressure. If the cyst gets ruptured, then kidney transplant and liver transplant is necessary.

Neoplastic cyst

The true intrahepatic neoplastic cyst is an uncommon condition. The cause of cystadenocarcinoma and cystadenomas is still not known but cystadenomas are similar to simple cysts that are present from birth and are of epithelial origin while cystadenocarcinoma is a cancerous tumor. The cystadenoma is a premalignant lesion which has a neoplastic transformation to cystadenocarcinoma which grows slowly and can increase to a diameter of 12 cm.

Hydatid Cyst

The hydatid cyst is caused by the parasitic Echinococcus granulosus which is an infection caused by a species of tapeworm that is transferable from animals to humans. The adult tapeworm is seen in the digestive tract of carnivores such as sheep, dogs or wolves. The eggs are released into the stool and are ingested by sheep, cattle’s or humans.

The larva grows and becomes encysted within the liver and hydatid cyst develops forming an outer layer of the inflammatory tissue and inner germinal membrane that produces daughter cysts.

Epidemiology

The development of the cyst in the liver is still not known because usually, they do not have any symptoms. It is seen in 5% of the population, but only 10-15% of the patients who have the symptoms of cyst are brought to medical attention. The hepatic cyst is seen during tests of other region or imaging or laparoscopy therapy.

Symptoms

Most of the liver cysts do not have any symptoms, but if the cyst becomes large then it may show the following signs:

  • Bloating
  • Feeling of fullness
  • Pain in the upper right part of the abdomen

If it has a parasitic cyst, then it shows symptoms like:

  • Fever
  • Severe skin itching
  • Blood in sputum

Diagnosis

The hepatic cyst is diagnosed with an ultrasound or a CT scan which is done only on patients who have such symptoms and require removal of a significant amount of cyst wall.

Treatment

Usually, liver cyst does not require surgery and go away on their own. But cysts which have symptoms should be removed surgically.

Removal of fluid from the cyst can be again filled within a couple of weeks.

Complete removal of the cyst will be the best treatment, especially for cystadenoma and cystadenocarcinoma types. It is done through laparoscopy where an instrument is inserted into the abdomen to precede the surgery.

Echinococcosis infection is often treated with surgery and up to two years of chemotherapy to reduce its symptoms. To address the parasitic worms, a course of drugs may be prescribed.

Natural remedies for Liver Cyst

If a person has a cyst in the liver, it should not be neglected because the cyst can grow or multiply itself. During the initial stages, doctors may ask to change the diet chart which may include:

  • Avoiding substances that damage liver cells like, alcohol, excessive level of sugar consumption, medication and drugs
  • Reduction of dairy products
  • Intake of good liver tonics
  • Drink raw vegetable juice
  • Take selenium supplement

Prevention

A liver cyst which is present from birth and is inherited cannot be prevented. But parasitic cyst can be avoided by maintaining a good hygiene and proper food handling in places where echinococcus infection is more such as Europe, Africa, Asia, Middle East, Central and South America. Even hunters should be safe and wear gloves while handling wild animals.

References

  1. http://www.innerbody.com/diseases-conditions/liver-cysts
  2. https://surgery.ucsf.edu/conditions–procedures/liver-cysts.aspx
  3. https://www.liverdoctor.com/liver-cysts-article/
  4. https://emedicine.medscape.com/article/190818-overview#showall
  5. https://www.webmd.com/digestive-disorders/polycystic-liver-disease-causes-symptoms-treatment#1
  6. https://www.liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/liver-cysts/#1503466638770-3f8b923f-afdb

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