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

Christopher H Henry,Andrew Dargan

doi:10.4172/2161-0703.1000229

Abstract

Simple hepatic cysts occur in less than 5% of the population. As the technology we use for imaging advances, so does the frequency with which we identify them. Simple cysts, as presented here, do not generally require aspiration. The majority of these cysts do not require treatment, however, those larger than 4 cm are recommended for surveillance. We present two cases of simple cysts that were followed for 15 years and managed differently. The experience we acquired from these cases illustrates challenges in understanding and management and an implication that, perhaps, conservative surveillance might be best.

Highlights

A 76-year-old male with chronic hepatitis B was noted on surveillance ultrasonography to have an asymptomatic right lobe hepatic cyst measuring 7.3 × 7.3 × 6.3 cm in 1998
Exam typically reveals an enlarged liver and tenderness to palpation in the right upper quadrant
Amoebic liver abscesses can radiographically appear similar to simple cysts as round, well-defined hypoechoic masses [5]

Summary

Introduction

A 76-year-old male with chronic hepatitis B was noted on surveillance ultrasonography to have an asymptomatic right lobe hepatic cyst measuring 7.3 × 7.3 × 6.3 cm in 1998. Mild intrahepatic ductal dilatation was noted, but the patient remained asymptomatic with normal liver function. Over the course of 15 years of surveillance, this patient’s hepatic cyst increased to a maximum size of 10 cm, without ever causing symptoms or lab abnormalities, only transient ductal dilatation and underwent spontaneous regression without intervention (Figure 1).

Results

Conclusion