Learn About Liver Cysts

Liver cysts, also known as hepatic cysts, are fluid-filled sacs that occur in your liver. These cysts are often benign (non-cancerous) and usually discovered by chance via magnetic resonance imaging (MRI) or computed tomography (CT) scans. 

Although most liver cysts cause no symptoms, early detection is critical for proper treatment of the cancerous or parasitic subtypes. Your doctor may treat your cysts with surgical techniques or medication. 

To learn more about liver cysts, including their causes, symptoms, diagnosis, management and treatment, risk factors, and complications, continue reading this article.

Causes of liver cysts

The exact cause of liver cysts is still unknown, but they may develop due to a defect present from birth. However, in some rare cases, liver cysts can be a sign of a more severe underlying condition, such as inherited polycystic liver disease, a parasitic infection called cystic echinococcosis or hydatid cysts, or liver cancer.¹

Signs and symptoms of liver cysts

The majority of individuals with benign or malignant liver cysts do not experience any symptoms. However, for those who do, the following signs and symptoms may be present:² 

• A dull ache in the upper right section of the abdomen 
• A swollen belly 
• Nausea and vomiting 
• A loss of appetite or feeling full quickly after eating 
• Shortness of breath 
• Noticeable lumps in the abdomen 
• Jaundice, which can occur when liver cysts obstruct bile ducts 
• Fever and sudden belly pain, which can occur if a cyst ruptures

Management and treatment for liver cysts

If you have harmless cysts in your liver that are not causing any symptoms, you don't need to do anything about them. But if the cysts are larger than 4 cm, your doctor should keep an eye on them. They can do this by using ultrasounds to check the size and stability of the cysts every 3 to 12 months. If the cysts don't change much for 2 to 3 years, you don't need ultrasounds anymore.

If you have liver cysts that are causing symptoms, there are three common procedures that can help.³ These procedures can either shrink the cyst or remove it completely. The three procedures are: 

• Percutaneous aspiration (removing the fluid from the cyst with a needle)⁴ 
• Laparoscopic deroofing (draining and removing part of the cyst wall, and stitching the walls together to prevent a recurrence)⁵
• Complete cyst excision (removing the entire cyst)³

Diagnosis of liver cysts

Most liver cysts don't cause any problems and detect by imaging tests. These tests include:⁶

• Ultrasound: This technique uses high-frequency sound waves to produce pictures and videos of your internal organs. Ultrasounds can often differentiate a simple cyst from a complicated one
• CT scan: This technique uses X-rays and a computer to produce three-dimensional pictures of your soft tissues and bones
• MRI: This technique uses a large magnet, radio waves, and a computer to create clear pictures of your organs and structures

If doctors find cysts on your liver during the test, they will do other checks to figure out what's causing them. They may ask about your medical history and perform blood tests to ensure the cyst is benign and not caused by parasites or other diseases.

It's important to consider other conditions that could be causing similar symptoms. This is called a differential diagnosis. For example, someone with abdominal pain might have a liver cyst, but other conditions like gallstones, ulcers, or liver abscesses can cause similar pain. Doctors can use imaging to help rule out some of these possibilities, and if needed, they may also perform other tests like an endoscopy to investigate further.

Risk factors

Certain risk factors of liver cysts can't be changed, like your age, genes, or congenital condition that you were born with. Some of these factors include^:7

• Polycystic liver disease: Liver cysts are congenital, meaning they are present at birth. Polycystic liver disease is more likely to affect you if a family member has the disease. If one family member has it, up to 50% of other family members may develop it too
• Female hormones: It is believed that female hormones might influence a number of factors responsible for the secretion and growth of liver cysts. Pregnancy and taking female hormones after menopause can also increase the risk
• Age: Liver cysts tend to multiply in number and become bigger as you get older
• Kidney cysts: In some cases, kidney dysfunction and severe kidney cysts can promote the occurrence of liver cysts
• Other factors: The influence of other factors like metabolic factors, diet, and smoking on the development of liver cysts has not been studied in depth yet

Complications

If a fluid-filled cyst in your liver is large enough, it can press on your bile duct and cause problems. This could lead to the cyst bursting inside your body or in your bile duct, which can cause an infection. 

Some types of cysts have specific problems associated with them. For example, some cysts can cause an allergic reaction that can be deadly, while others can turn into cancer that is hard to treat.^3,8

FAQs

How can I prevent liver cysts?

Liver cysts are typically present at birth, and thus, they are considered congenital.⁹

Are liver cysts cancerous?

Liver cysts don't usually turn into cancer, but if they do, surgery is needed. Doctors only worry about a small number of cysts that have the potential to become precancerous (about 1% to 5%). Out of those, about 30% may turn into cancer.

Are liver cysts common? 

Many people in the United States (around 15% to 18%) and worldwide (around 5% to 10%) have liver cysts.

Do liver cysts go away on their own?

Medical research has found that harmless cysts in the liver can sometimes disappear by themselves and do not need treatment. Usually, these cysts are not dangerous and do not cause any problems. However, if the cysts grow too big, they may require surgical removal.¹⁰

When should I see a doctor?

Liver cysts can grow without you knowing until a doctor finds them during a routine check-up. If you find out you have liver cysts, talk to your doctor about what to do next. You may want to ask your doctor questions about the cysts, such as whether they are harmful, what tests you need, or whether they can be removed if they cause pain or discomfort. Your doctor may also want to check if there are cysts in other parts of your body. It's important to ask questions so you can understand what is happening and what to expect.

Summary

Liver cysts can develop due to a defect present from birth. However, they may be a sign of a severe underlying condition such as polycystic liver disease, echinococcus, or liver cancer. 

Most individuals with benign or malignant liver cysts don't experience any symptoms, but those who do may have a dull ache in the upper right section of the abdomen, a swollen belly, or feelings of nausea and vomiting. 

Management and treatment options vary, depending on the cyst size and symptoms. Regular monitoring of cysts and making dietary changes may help prevent problems.