Solitary Non-parasitic Hepatic Cysts Research Articles

Laparoscopic excision of large, solitary non-parasitic hepatic cysts: A report of two cases

Laparoscopic excision of large, solitary non-parasitic hepatic cysts: A report of two cases

A small solitary non-parasitic hepatic cyst causing an intra-hepatic bile duct stricture: a case report

IntroductionWe report an unusual presentation of a small hepatic cyst causing cholangitis.Case presentationA 70-year-old Asian man was hospitalized for aggravated chronic pain in the right upper portion of his abdomen. Fever developed after admission. Laboratory tests revealed elevated hepatobiliary enzymes, inflammatory markers and carbohydrate antigen 19-9 without hyperbilirubinemia. Ultrasound and computed tomography demonstrated dilatation of the left intra-hepatic bile ducts. Endoscopic retrograde cholangiopancreatography showed that the right intra-hepatic bile ducts were normally filled with contrast medium, but the left intra-hepatic bile ducts were not seen in the confluence. A left hepatectomy was performed because a hidden malignancy could not be excluded. The surgical findings showed no tumor around the bile duct but rather a 2 cm cyst in segment four of Couinaud's category of the liver around the hilum. The pathology report was a solitary non-parasitic hepatic cyst compressing the bile duct.ConclusionA very small solitary hepatic cyst might cause hepatic duct stricture if it is located near the hepatic hilum, and should be considered in the differential diagnosis of a hepatic duct stricture.

Sclerosant Therapy as First-Line Treatment for Solitary Liver Cysts

Aim: The aim was to determine the outcome from percutaneous sclerosing treatment of solitary non-parasitic hepatic cysts. Methods: The results of treatment of patients with symptomatic solitary non-parasitic hepatic cysts treated between 1995 and 2000 were reviewed. Results: There were 23 women and one man with a median (range) age of 59 (34–79) years. The median (range) diameter of the cysts was 10 (5–24) cm. Five patients were treated by laparoscopic fenestration ab initio as they also required a cholecystectomy because of gallstones. The remaining 19 patients underwent percutaneous sclerotherapy. In one just aspiration was successful without further treatment. In six contrast leaked from the cyst and five of these had laparoscopic fenestration. Twelve patients had sclerosant treatment with good results at a median (range) follow-up of 35 (6–60) months in 10 patients. Good results were also obtained in 10 of the 12 patients who had fenestration.

Long-term results of laparoscopic unroofing of symptomatic solitary nonparasitic hepatic cysts.

The long-term results of laparoscopic unroofing for symptomatic solitary nonparasitic hepatic cysts have not been well demonstrated. During the last 8 years, five patients with symptomatic solitary nonparasitic hepatic cysts underwent laparoscopic unroofing. Their symptoms were right-upper-quadrant pain (in three patients) and epigastric pain (in two). Accompanying the hepatic cysts were acute cholecystitis in one case and adenomyomatosis of the gallbladder in another. Perioperative data, including operation time, estimated blood loss, complications, hospital stay, and mortality rate, were evaluated. There were no conversions to open laparotomy. Cysts were located in segments 4 and 5 in three patients, segment 3 in one, and segment 8 in another, and the mean size of the cysts was 10.4 cm in diameter (range: 7-18 cm). In four cases cholecystectomy was performed simultaneously. Mean operation time, estimated blood loss, and postoperative hospital stay were 182 minutes (range: 72-270), 168 mL (range: minimal to 800 mL), and 9.4 days (range: 7-12), respectively. There were no deaths or instances of major morbidity. During a mean follow-up period of 66 months (range: 35-102), one patient had a recurrent lesion requiring reoperation. Laparoscopic unroofing is a feasible and safe procedure for patients with symptomatic solitary nonparasitic hepatic cysts. Strict patient selection, accurate location of the cyst within the liver, and a sufficiently wide unroofing technique are needed for the outcome to be successful.

Primary squamous cell carcinoma within a solitary nonparasitic hepatic cyst

A case report is presented of a patient who developed primary squamous cell carcinoma in a solitary nonparasitic hepatic cyst. The clinical presentation, operative management, and pathological findings are discussed. This case is unusual as the histology demonstrates transition from columnar cell architecture through squamous cell metaplasia and carcinoma in situ to invasive carcinoma.

Solitary nonparasitic hepatic cyst causing abdominal distension and respiratory distress in a newborn

This is a report of a girl infant born with a protuberant abdomen and respiratory distress. A cystic mass was excised from the liver.

Solitary nonparasitic hepatic cysts.

We reviewed eight cases of nonparasitic solitary hepatic cysts found in two community hospitals during a ten-year period ending in 1978. Diagnostic evaluation consisted primarily of ultrasonography, arteriography, liver scan, and upper gastrointestinal contrast studies. Six symptomatic patients were operated upon and two nonsymptomatic patients were observed. There have been no recurrences or operative deaths in this series. It is concluded that (1) solitary hepatic cysts are not as rare as previously thought; (2) the tools of ultrasonography, arteriography, and liver scan may be expected to increase diagnostic accuracy; and (3) operative therapy must be individualized to both the general condition of the patient and the location of the cyst.

Diagnosis and treatment of solitary nonparasite hepatic cyst.

Total of 10 cases of nonparasitic cyst of the liver encountered during the past 20 years have been presented together with the 287 cases collected from the Japanese literature up to 1973 inclusive. The advent of the newer effective diagnostic procedures in recent years made it possible to establish preoperative diagnosis resulting in rapid increase of reported cases. Among them celiac and superior mesenteric angiography coupled with echotomography seem to be the most effective. Differentiation from hydatid cyst presents problems for which angiographic signs offer valuable clues. Total excision of the cyst has been advocated and accomplished successfully because of the relative ease of enucleation from the surrounding structures.

Solitary non-parasitic hepatic cyst demonstrated by angiography. Report of a case and its differential diagnosis.

Summary A case report of a Jamaican woman who had a non-parasitic cyst of the right lobe of the liver demonstrated preoperatively by angiography is described. It is suggested that angiography is the best available method for the demonstration of this rare condition. The differential diagnosis of avascular space-occupying lesions of the liver is discussed.

Solitary nonparasitic hepatic cysts. Report of oldest known case and review of the literature.

SOLITARY nonparasitic hepatic cysts occur with sufficient rarity to merit the reporting of each case. The opportunity to treat such a lesion has prompted this case report and review of the literature. Report of a Case The patient, a 90-year-old woman, was admitted to the Naval Hospital, Oakland, Calif, complaining of steady left upper abdominal pain of 12 days' duration associated with nausea, intermittent emesis, constipation, a 1.4-kg (3-lb) weight loss, and increasing abdominal girth. In 1962 an attack of acute cholecystitis necessitated a cholecystostomy. Past medical history and review of systems were otherwise unremarkable. The patient was in moderate distress from abdominal pain. Vital signs were normal. Bilateral lenticular opacities and decreased auditory acuity were present along with moderate dorsal kyphosis, an increased posteroanterior diameter of the chest, and a few scattered rales at the lung bases. Abdominal distention was evident. There was a firm cystic mass which could

Large solitary nonparasitic cyst of the liver. Report of a case in which both major hepatic lobes were involved.

Solitary nonparasitic hepatic cysts are rare. Geist 4 collected 193 cases from the world literature up to 1954. Subsequently, 36 additional articles have appeared, making the total well over 200 cases. Others 1-3,5-9 have presented extensive reviews of the pathogenesis, diagnosis, and natural history, as well as treatment utilized in various forms of hepatic cystic disease. The present case of a solitary multilocular cyst is worthy of report, because the main cavity involved the whole of the left hepatic lobe, as well as the entire superior surface of the right lobe. The extent of involvement presented a difficult therapeutic problem at the time of surgery. In contrast to polycystic disease of the liver, which is commonly associated with cystic changes in other organs and frequently terminates fatally at an early age, solitary cysts often produce little or no disability. Characteristically, symptoms first appear in the fourth or fifth decade, with