Liver Cysts

Liver cysts, also known as hepatic cysts, are fluid-filled sacs on your liver. Nearly all are benign (noncancerous). Benign liver cysts, sometimes called simple cysts, are common. Most don’t cause issues or need treatment.

They tend to occur in people living in rural or underdeveloped areas.

Providers use surgery to treat liver cysts that are cancerous or big enough to cause symptoms. But this is rare. Only about 5% of all liver cysts are cancerous. And few cysts grow large enough to cause symptoms.

Are liver cysts dangerous?

While nearly all liver cysts are harmless, two types of cystic liver disease can be more serious:

• Hydatid disease (echinoccal or hydatid cysts): A parasitic infection that causes cysts on your liver and other parts of your body. It can be fatal without treatment.
• Polycystic liver disease (PLD): A rare disorder that causes clusters of simple cysts on your liver. Over time, PLD can cause your liver to enlarge.

Surgery and medications can treat these conditions and prevent major complications.

Symptoms of liver cysts

This condition doesn’t usually cause symptoms. But cysts that are big enough to place pressure on nearby organs may cause:

• Dull pain in the upper right area of your belly (most common symptom)
• Bloating or a swollen belly
• Lack of appetite or feeling full after eating very little food
• A lump in your belly that you can feel with your fingers
• Nausea and vomiting
• Shortness of breath

Liver cyst causes

Most liver cysts are present at birth. Medical experts aren’t sure what causes them.

Most people get diagnosed when they’re 40 or older. More females have liver cysts, but experts don’t know why. It’s possible that there’s a link between some kinds of liver cysts and estrogen. Females have more of this hormone than males.

Complications of this condition

Most people with hepatic cysts don’t have major issues. But it’s possible that a large cyst may block your bile ducts (bile duct obstruction). This can lead to jaundice and be serious without treatment. A cyst that bursts can cause a severe infection. Signs include fever and intense belly pain.

It’s important to seek treatment ASAP if you have a liver cyst and notice signs of a complication.

How doctors diagnose this condition

Usually, healthcare providers find liver cysts while doing imaging tests for other conditions. Imaging tests that reveal liver cysts include:

• Ultrasound
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)

You may need more tests if your provider finds a cyst that may be related to a serious condition. They may suggest more detailed imaging, blood tests or a liver biopsy.

How are liver cysts treated?

Most simple liver cysts don’t need treatment. But healthcare providers use surgery to remove cysts that are precancerous or cancerous. They may remove large cysts. Generally, “large” means a cyst that’s more than 4 centimeters (1 1/2 inches) across. Large liver cysts are more likely to cause symptoms.

Procedures to treat liver cysts that may cause health issues include:

• Cyst fenestration: This surgery removes the cyst’s wall, causing it to collapse.
• Percutaneous aspiration: Using imaging guidance, providers insert needles or catheters into liver cysts and drain the fluid. This approach can relieve symptoms fast. But you’ll likely need fenestration to keep the cyst from reforming.
• Hepatic resection: This surgery removes areas of your liver affected by cysts.
• Transarterial embolization (TACE): A provider injects anti-cancer drugs into one of the arteries that supply blood to your liver. Then, they inject a substance that blocks the artery. The substance traps the anti-cancer drugs so they destroy cancerous liver cysts.

You may need a liver transplant to treat polycystic liver disease that doesn’t respond to medicines or surgery. But this is very rare.

When should I see my healthcare provider?

Often, liver cysts grow undetected until they show up during routine imaging tests. Some questions to ask your healthcare provider that may help you understand next steps include:

• How do I know whether my cyst is benign or cancerous?
• What kind of tests will I need?
• Can you remove a cyst if it’s causing pain or discomfort?
• Will you monitor the cyst’s size and location over time?
• Should I get other tests to check for cysts in other parts of my body?

What can I expect if I have a liver cyst?

Your outcome depends on the type of cyst.

Most benign (noncancerous) liver cysts never cause symptoms. Sometimes, they go away without treatment. Your healthcare provider may suggest follow-up imaging tests to confirm that the cysts aren’t growing or changing. A typical follow-up schedule is every three months for a year.

You may need surgery to remove cancerous or large benign liver cysts. Your healthcare provider may schedule follow-up tests based on your situation.

Is there anything I can do to feel better?

Some people need surgery or other treatments for their liver cysts. If that’s your situation, ask your healthcare provider about how to manage treatment side effects. Have them explain what to expect during recovery.

If you’ve just learned that you have a liver cyst, keep in mind that they’re common and usually harmless. Your provider will let you know if you need future tests to keep an eye on it.

What should you avoid if you have liver cysts?

There’s no need to make changes to your routine unless your healthcare provider recommends it.

In the meantime, you can care for your liver by eating foods that supply it with the nutrients it needs. Protect it by choosing not to drink alcohol or drinking only in moderation.

Can a CT scan tell if a liver cyst is cancerous?

No, but it can help your healthcare provider get closer to a diagnosis. CT scans show detailed pictures that help providers know if a mass is a simple cyst, a tumor or a mix of fluid and tissue. You’ll need a liver biopsy to test the contents of the mass to know for sure if it’s cancer or not.