Hemorrhagic hepatic cysts mimicking biliary cystadenoma

The hemorrhagic simple hepatic cyst is extremely rare and can sometimes be confused with biliary cystadenoma or cystadenocarcinoma.Here we present two cases of huge hemorrhagic simple hepatic cysts. Case 1 was a 43-year-old man with a cystic lesion measuring 13 cm×12 cm in the right hepatic lobe. Ultrasound and computed tomography showed several mural nodules on the irregularly thickened wall and high-density straps inside the cyst.Case 2 was a 60-year-old woman with a huge cyst measuring 15 cm ×14 cm in the central liver.Ultrasound and magnetic resonance imaging showed the cystic wall was unevenly thickened and there were some flame-like prominences on the wall.The iconographic representations of the two cases mimicked biliary cystadenoma.Cystectomy and left hepatectomy were performed for the two patients, respectively.Both patients recovered quickly after their operations and showed no recurrence.

Percutaneous aspiration and sclerotherapy of a giant simple hepatic cyst causing obstructive jaundice:A case report and review of literature

BACKGROUND Giant simple hepatic cysts causing intrahepatic duct dilatation and obstructive jaundice are uncommon.A variety of measures with different clinical efficacies and invasiveness have been developed.Nonsurgical management,such as percutaneous aspiration and sclerotherapy,is often applied.CASE SUMMARY The case is a 39-year-old female with a 5-mo history of cutaneous and scleral icterus,loss of appetite,and dark urine.Lab tests showed jaundice and liver function abnormalities.Imaging revealed a giant simple hepatic cyst obstructing the intrahepatic bile ducts.A combination of percutaneous catheter aspiration and lauromacrogol sclerotherapy was successfully performed and the effects were satisfactory with the size of cyst decreasing from 13.7 cm×13.1 cm to 3.0 cm×3.0 cm.Further literature review presented the challenges of managing giant simple hepatic cysts that cause obstructive jaundice and compared the safety and efficacy of a combination of percutaneous aspiration and lauromacrogol sclerotherapy with other management strategies.CONCLUSION Giant simple hepatic cysts can cause obstructive jaundice,and a combination of percutaneous catheter aspiration and sclerotherapy with lauromacrogol are suggested to treat such cases.

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.