Successful aspiration and ethanol sclerosis of a large, symptomatic, simple liver cyst: case presentation and review of the literature.
Simple liver cysts are congenital with a prevalence of 2.5%-4.25%. Imaging, whether by US, CT or MRI, is accurate in distinguishing simple cysts from other etiologies, including parasitic, neoplastic, duct-related, and traumatic cysts. Symptomatic simple liver cysts are rare, and the true frequency of symptoms is not known. Symptomatic simple liver cysts are predominantly large (> 4 cm), right-sided, and more common in women and older patients. The vast majority of simple hepatic cysts require no treatment or follow-up, though large cysts (> 4 cm) may be followed initially with serial imaging to ensure stability. Attribution of symptoms to a large simple cyst should be undertaken with caution, after alternative diagnoses have been excluded. Aspiration may be performed to test whether symptoms are due to the cyst; however, cyst recurrence should be expected. Limited experience with both laparoscopic deroofing and aspiration, followed by instillation of a sclerosing agent has demonstrated promising results for the treatment of symptomatic cysts. Here, we describe a patient with a large, symptomatic, simple liver cyst who experienced complete resolution of symptoms following cyst drainage and alcohol ablation, and we present a comprehensive review of the literature.
Blonski
Wojciech C
WC
Gastroenterology Division, University of Pennsylvania, Philadelphia, PA 19104, United States.
Campbell
Mical S
MS
Faust
Thomas
T
Metz
David C
DC
D003560:Cysts / Q000473:pathology / Q000628:therapy*; D004322:Drainage; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D012598:Sclerosis / Q000139:chemically induced; D015911:Sclerotherapy; D014057:Tomography, X-Ray Computed
D012597:Sclerosing Solutions; D000431:Ethanol