Liver Cysts Flashcards
What are the four types of cysts you can get in the liver
Simple cysts
Cystic neoplasms
Hydatid cysts
Polycysts ( ADPLD)
Where are simple cysts most commonly found
Right lobe of liver
What is a simple cyst
Fluid filled epithelial lined sacs
Thought to be congenitally malformed bile duct cells
How do simple cysts present
There are asymptomatic
Incidentally found of Scans
Some pts experience - abdo pain, early satiety due to mass effect
What investigations would you carry out for simple cysts
USS
LFTs will be normal, GGT may be raised
CEA and CA19-9 raised in some cases.
How would you manage simple cysts
No management required if patient asymptomatic
If above 4cm then surveillance required to check for growth - 3,6,12 months. If no change for 2-3 years then no need for more surveillance
If symptomatic:
US guided aspiration
Laparoscopic de-roofing
What is the 2 most common causes of cysts on the liver
ADPLD
ADPKD
What are the clinical features of Polycystic liver disease
Asymptomatic mostly
RUQ pain as cysts grow in size - may get Portal HTN if cysts big enough to compress vein.
What investigations would you carry out for ADPLD and what do you see
USS
For it to be called PLD - need to have 20 or more cysts more than 1cm big
How would you manage ADPLD
Leave alone and monitor
US guided aspiration
Laparoscopic de-roofing
What are cystic neoplasms
Pre-malignant lesions due to abnormal proliferation of the biliary epithelium
What is the most common type of cystic neoplasm
Cystadenoma
What are the clinical features of cystic neoplasms
Most are asymptomatic
But can get pain and anorexia
How would you investigate cystic neoplasms
CEA, CA19-9 become elevated + ALP. Rest of LFT normal
CT contrast
Avoid aspiration as can seed mets in other places
How would you manage cystic neoplasms
Liver lobe resection
