What are Liver Cysts?


Liver cysts are usually non-cancerous, which means they are benign tumours. Initially, there are no signs of pain or other symptoms with liver cysts. 

The prevalence of hepatic cysts is believed to be 15-18% in the United States. The mortality rate of the cysts varies with the cause, and it increases if the complications of the cysts increase.2 Only 10 to 15% of patients with liver cysts show actual signs and symptoms. They do not require treatment, but a patient should seek immediate medical care if the condition has grown to intense pain. 

The overall size of a liver cyst can be considered as that of a pinhead or 4 inches.1 The hepatic cysts are of the following types:

  1. Simple cysts 
  2. Congenital cysts 
  3. Acquired cysts 

Simple cysts are more common. They are found in 2-18% of the population. Simple cysts range from less than 1 cm to 30 cm. They usually have two septa. The majority of simple cysts are congenital and are formed from the biliary ducts. Simple cysts occur in polycystic liver disease, biliary hamartomas, and Caroli disease.

Acquired cysts have echinococcal cysts. The consumption of food contaminated with the parasite Echinococcus granulosus causes these cysts. Over time, the cysts develop a thick and calcified wall with surrounding daughter cysts and several other intricate features.2 

Causes of liver cysts

The exact cause of liver cysts is unknown. They are believed to be present at the time of our birth and then grow slowly. Most liver cysts are detected in adulthood. They can also be caused by the above-mentioned parasite.

Polycystic liver disease can result in liver cysts. It has a prevalence rate of 0.13% to 0.9% in the United States. This disease causes the liver to become enlarged and develop multiple cysts.2

Signs and symptoms of liver cysts

Hepatic cysts usually begin as benign tumours with no apparent signs or symptoms. A small percentage of the population has signs and symptoms of liver cysts which are as follows:

  1. Lack of appetite
  2. The feeling of the presence of large lumps in the stomach 
  3. Feeling short of breath 
  4. If the liver cysts grow significantly to the extent that they block the bile ducts, it can cause jaundice
  5. Haemorrhage, rupture, or damage to the biliary tree3
  6. Fever or sudden onset of pain (in case of bleeding from the cyst)

Management and treatment for liver cysts

Hepatic cysts smaller than 4 cm or simple cysts with no signs and symptoms require no treatment. They are given less medical attention. However, hepatic cysts larger than 4 cm need medical care and immediate attention. Regular monitoring via ultrasound at 3 or 12 month intervals is done. If there is no growth in the size of the cyst, then there is no need for further follow-ups. 

The first-line treatment for the treatment and management of hepatic cysts is a percutaneous aspiration. It is usually performed alone or with a sclerosing agent such as alcohol or minocycline hydrochloride. When percutaneous aspiration is carried out without sclerosing agent, the chances of recurrence are not decreased. If performed with a sclerosing agent the rate of recurrence is significantly reduced. It is labelled as the first-line agent because of its non-invasive approach, which makes it considerably safe.

On the other hand, laparoscopic deroofing has a reduced recurrence rate. However, it comes with increased morbidity.

Complete cyst excision is considered the last option. It should be performed only if it is necessary. 


Are liver cysts common?

Liver cysts are fairly common. Only 15-18% of individuals in the United States get hepatic cysts. 

Who is at risk of liver cysts?

Hepatic cysts are congenital, meaning they can occur via genetic factors. Furthermore, one can get liver cysts via echinococcus. Therefore, people exposed to contaminated food or water are at more risk of getting liver cysts. Patients suffering from Polycystic liver disease (PCLD) can have cysts due to defects in the biliary cilia. 

Are liver cysts cancerous?

In the initial stages, liver cysts are benign and noncancerous. However, an increase in the size of a cyst up to 4 cm can cause it to be troublesome. Therefore, cysts are noncancerous in the initial stages but can cause pain and other symptoms in the later stages. 

How is a liver cyst diagnosed?

Liver cysts can be diagnosed via ultrasound. Regular follow-ups are required to monitor the size of the cyst.

How can I prevent liver cysts?

There is no possible way to prevent liver cysts, as the exact mechanism of action is not clear. The least you can do is to avoid taking contaminated food as it may have echinococcus parasites. This parasite (Echinococcus granulosus) results in echinococcal liver cysts.  

When should I see a doctor?

One should consult a doctor when the signs and symptoms of the liver cysts are apparent. These signs and symptoms may include upper abdominal discomfort or fullness, shortness of breath, jaundice, or feeling of the presence of something in the belly. These signs and symptoms result when the cysts grow larger.


Liver cysts are fluid-filled sacs formed in the liver. 15 to 18% of the individuals in the United States get liver cysts. Usually, they are benign and noncancerous. However, if they increase in size, they can be fatal. The exact cause of liver cysts is unknown. It is supposed that echinococcus parasites may cause them. If you suspect that you have liver cysts, make an appointment with your doctor to take appropriate action.


  1. Liver cysts [Internet]. Cleveland Clinic. [cited 2023 Jan 26]. Available from: https://my.clevelandclinic.org/health/diseases/17178-liver-cyst
  2. Mavilia MG, Pakala T, Molina M, Wu GY. Differentiating cystic liver lesions: A review of imaging modalities, diagnosis and management. J Clin Transl Hepatol [Internet]. 2018;6(2):1–9. Available from: http://dx.doi.org/10.14218/jcth.2017.00069
  3. Bernshteyn MA, Masood U. Hepatic Cyst. StatPearls Publishing; 2022.
  4. Violations [Internet]. Com.sg. [cited 2023 Jan 26]. Available from: https://www.singhealth.com.sg/patient-care/conditions-treatments/Liver-Cyst
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Syed Sharf ud Din

Doctor of Pharmacy, University of Central Punjab

Syed Sharf ud Din is a fourth-year pharmacy student. While still in pharmacy school, he has vast interests in biopharmaceutics and pharmacy practise. With an ardent skill of writing combined with background of health sciences, he is curating perfectly designed health-related articles for the general public. He aims to continue his skills and interests in the future to contribute to breakthroughs in pharmaceutical sciences.

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