Are liver cysts a cause for concern?

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Anthony L. Komaroff, MD
Internal Medicine
Your liver cysts are probably "simple cysts." These are collections of clear fluid within the liver. The fluid is surrounded by a thin membrane. Such cysts are common. They generally cause no symptoms.

Most liver cysts were never found before modern imaging techniques such as ultrasound and CT scans came along. Simple liver cysts are usually found when doctors order these tests to investigate some other problem.

These cysts range from just a few millimeters in diameter to a size larger than a grapefruit. Most are on the small size, no more than a few centimeters across. Large cysts are much more common in older women than in men.

Large liver cysts sometimes cause ongoing upper abdominal discomfort. Sudden, severe pain may mean that bleeding has developed within a cyst. Cysts can also become infected. However, these complications are uncommon.

Simple liver cysts, no matter how large, never transform into cancer.

Polycystic liver disease is an inherited disorder in which the liver is filled with cysts. It also damages the kidneys. I doubt that this is your problem.

Other types of cysts do call for vigorous medical management. While a very thin membrane envelops simple cysts, cystadenomas and cystadenocarcinomas are surrounded by thickened walls. These are east to detect on imaging tests. A thick-walled cyst requires additional testing to test for cancer.

Abscesses in the liver can look like cysts to the radiologist. If you have fever and pain, your doctor might believe you have a liver abscess rather than a simple cyst.

In some rural areas of the world, hydatid cysts of the liver are caused by a parasite whose larvae are spread to humans by infected dogs. But hydatid cysts are very rarely found in the United States.

My strong guess is that your liver cysts should be no cause for concern, but talk to your doctor to be certain.
Ajay K. Sahajpal, MD
Transplant Surgery

Simple liver cysts are rarely a cause for concern. Rarely, they can rupture or become infected and require aspiration or drainage or rarely laparoscopy and cyst deroofing. Although, it is important to rule out a solid component with the cyst. If there is a solid component, it should be evaluated by a liver surgeon for recommendations.

Liver cysts can be caused by different processes. Some are caused by serious infections, some have a risk of becoming cancerous but many are low risk are best left alone. A liver team including a surgeon should review the imaging to ensure that it is safe to watch cysts.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.