Nonparasitic hepatic cysts constitute a heterogeneous group of disorders. A proper diagnosis of hepatic cyst is necessary in order to adopt the best treatment. The term hepatic cyst usually refers to simple hepatic cysts. Nonparasitic hepatic cysts are also linked to genetic disorders such as polycystic liver disease (PLD) with/without autosomal dominant polycystic kidney disease (ADPKD) or Caroli disease. Generally, patients with nonparasitic hepatic cysts less than 3 cm are asymptomatic. These cysts become symptomatic when are large, multiple, or complicated. Percutaneous abdominal ultrasound is the best imaging modality to diagnose hepatic cysts but must be completed by other imaging and serological tests. It is important to differentiate simple hepatic cyst from hydatid cyst, cystadenoma, and cystadenocarcinoma before proceeding with the treatment. Sometimes the diagnosis is very challenging. Asymptomatic single liver cysts need only surveillance, but symptomatic and complicated ones require therapeutic intervention. Percutaneous aspiration of the cyst under ultrasound guidance is a mini-invasive procedure generally associated with sclerotherapy. The highest success rates were reported for laparoscopic or open cyst fenestration. Liver transplantation is indicated for patients with severe PLD.
Part of the book: Recent Advances in Liver Diseases and Surgery