Current management of noninfectious hepatic cystic lesions: A review of the literature

Abstract

Nonparasitic hepatic cysts consist of a heterogeneous group of disorders, which differ in etiology, prevalence, and manifestations. With improving diagnostic techniques, hepatic cysts are becoming more common. Recent advancements in minimally invasive technology created a new Era in the management of hepatic cystic disease. Herein, the most current recommendations for management of noninfectious hepatic cysts are described, thereby discussing differential diagnosis, new therapeutic modalities and outcomes. Key words: simple hepatic cyst; Noninfectious; Polycystic liver disease; Cystadenoma; Cystadenocarcinoma; Caroli's disease; sclerotherapy; Fenestration Core tip: Nonparasitic hepatic cysts consist of a broad spectrum of entities ranging from benign developmental cysts to malignant neoplasms. With recent advancements in diagnostic studies, hepatic cysts are becoming more frequent and better understanding of risk factors, management and long-term outcomes, and further development of current therapeutic modalities are needed.

Fieber und rezidivierende Koliken nach Cholezystektomie

“…Es konnte jedoch die Aminosäureaustauschvariante c.2446A > G (p.Arg816Gly) in Exon 20 des ABCB-4-Gens in heterozygoter Form nachgewiesen werden, deren pathogenetische Relevanz bisher nicht in der publizierten Literatur beschrieben ist. [4]. Rein histologisch ist eine Caroli-Erkrankung aufgrund der Gallengangsveränderungen nicht sicher auszuschließen.…”

Cysts and Polycystic Liver Disease

“…Most cysts measure less than 3 cm and are asymptomatic [ 2 ]. Microscopically, they are lined by a single layer of cuboid or columnar epithelial cells, resembling biliary epithelial cells.…”

“…CT scan (Fig. 8.10 ) shows fl uid attenuation with no contrast enhancement, while MRI demonstrates hyperintense on T2-weighted and hypointense on T1-weighted images [ 2 ] (Fig. 8.11 ).…”

“…Sometimes, these lesions are not easily differentiated at initial presentation or by imaging studies, and management can become challenging [ 2 ]. Symptoms can be various; in the worst cases symptoms can be accompanied with an occupation of space syndrome that in PCLD can lead to liver transplantation for abdominal organ and big vessel compression.…”

A Tale of Two Cysts: Disparate Outcomes of Two Hepatic Cysts

“…Throughout this surveillance period, his chronic hepatitis B was well controlled with antiviral therapy. After discussion of treatment options, the decision was made to manage the cyst conservatively with continued surveillance [1]. Over the next five years, annual MRI or ultrasound showed no change in size.…”