[Fat Bear Science] A "cyst" was found on the liver during a physical examination. Is it cancer? How to treat it? Click here to find out

"Doctor, I have a 3 cm cyst on my liver. Is this serious? Is it cancer?"

Recently, Mr. Wang had a company physical examination at the Physical Examination Center of the Affiliated Cancer Hospital of Chongqing University. When he received the examination report, he found that there was a "problem" with his liver. In a hurry, Mr. Wang quickly found a doctor to solve his doubts.

In fact, with the changes in environment and diet, as well as the precision of medical testing equipment, the detection rate of liver cysts is getting higher and higher, and a certain proportion of citizens will have the words "liver cysts" on their physical examination reports. So, what exactly is liver cyst? Is it harmful to the human body? Is it cancer? How to treat it? ......

March 18th is World Liver Day, let’s talk about liver cysts.

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Li Fang

Director of the Ultrasound Medicine Department of the Affiliated Cancer Hospital of Chongqing University, chief physician and master's supervisor.

His main research direction is ultrasonic diagnosis and interventional treatment of tumors. He is currently a member of the Standing Committee of the Tumor Ultrasound Therapy Committee of the Chinese Anti-Cancer Association, Chairman of the Ultrasound Therapy Committee of the Chongqing Anti-Cancer Association, Chairman of the Ultrasound Committee of the Chongqing Medical Biotechnology Association, Standing Committee Member of the Youth Committee of the Ultrasound Intervention Committee of the Interventional Physicians Branch of the Chinese Medical Doctor Association, and Member of the Interventional Ultrasound Professional Committee of the Chinese Society of Ultrasound in Medicine and Engineering.

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Luo Xianzhang

Deputy Chief Physician of the Hepatobiliary and Pancreatic Tumor Center of the Affiliated Cancer Hospital of Chongqing University, Doctor of Medicine.

Graduated from Tongji Hospital of Huazhong University of Science and Technology, he is proficient in the diagnosis and treatment of hepatobiliary, pancreatic and spleen surgical diseases, and has been engaged in basic and clinical research on liver cancer for a long time. He is good at the diagnosis and treatment of hepatobiliary, pancreatic and spleen tumors, and has independently completed various open surgeries and laparoscopic surgeries. He is good at various punctures, biliary stent implantation, ERCP and other routine hepatobiliary and pancreatic surgeries. He has rich experience in the treatment of perioperative liver inflammatory response syndrome.

Liver cysts are "blisters" on the liver

Liver cysts are a general term for all cystic lesions that grow on the liver. They are common benign liver diseases with a clinical detection rate of 1% to 2%. They are more common in women than in men, with a male-to-female ratio of 1:4. Liver cysts can be single or multiple, which are medically called single liver cysts and multiple liver cysts.

Liver cysts can be superficial or deep in the liver parenchyma, and some can even be close to large blood vessels. They can range in size from a few millimeters to occupying the entire liver. The first symptoms of liver cysts can begin at any age, but they often occur between the ages of 20 and 50. The older you are, the more likely you are to find one.

Cysts are like closed "bubbles", with a fibrous cyst wall composed of layers of secretory cells, and the cyst cavity is filled with clear, colorless or light yellow, sterile, protein-rich cystic fluid. Most liver cysts are formed for unknown reasons, and they may be congenital, hereditary, or later in life.

The diagnosis of liver cysts is not difficult and mainly relies on imaging examinations. The detection rate of liver cysts by ultrasound can reach 98%.

Chongqing University Cancer Hospital

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Indications for ultrasound-guided cyst puncture and sclerosis

1. Single or multiple cysts with a diameter greater than 5 cm;

2. Patients with obvious clinical symptoms caused by cysts, such as upper abdominal discomfort, abdominal distension or abdominal pain caused by liver, pancreatic or spleen cysts;

3. Compression of surrounding organs causing secondary complications;

4. Cyst with infection;

5. Cysts that are in danger of rupture or torsion.

Most liver cysts do not become cancerous.

Liver cysts generally have no clinical symptoms and are only discovered during routine physical examinations such as ultrasound or CT scans. Most liver cysts remain in a "static" state for a long time and do not grow, rupture, bleed, or become infected, so no special treatment is required. However, the existence of liver cysts cannot be completely ignored. A small number of patients may experience intracystic bleeding, causing the cyst fluid to be bloody or accompanied by blood clots, and sometimes secondary infection may occur, requiring regular follow-up.

If you experience any uncomfortable symptoms, you need to seek timely treatment, such as gastrointestinal symptoms, such as loss of appetite, nausea and vomiting, abdominal pain, abdominal mass, jaundice, etc. Or when the cyst gradually increases in size, complications occur, or secondary infection, bleeding, torsion occurs, these situations require timely treatment.

It is certain that liver cysts are benign diseases and most of them will not turn into cancer, but we still need to be vigilant. For example, the cyst wall develops from smooth to nodular, which may be accompanied by an increase in tumor marker levels, which may indicate cancer; liver cystadenocarcinoma may be mistakenly diagnosed as liver cysts; multiple liver cysts sometimes need to be differentiated from intrahepatic bile duct cystic dilatation.

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Questions about liver cysts

one,

What are the types of liver cysts?

1

Congenital liver cyst

Normally, more than 90% of cysts are congenital liver cysts (also called true cysts). The cyst wall is composed of epithelial cells, and the cyst fluid is mostly colorless or transparent. The cyst originates from the aberrant bile duct or the developmental disorder of the intrahepatic bile duct and lymphatic vessels. Some patients develop polycystic liver and polycystic kidney due to chromosome-negative genetic diseases.

2

Traumatic liver cyst

Related to trauma.

3

Tumorous liver cyst

Including teratoma, cystic lymphangioma, cystadenoma, etc.

4

Inflammatory liver cysts

Cystic dilatation of the bile ducts caused by inflammation or obstruction by stones.

5

Parasitic liver cysts

As the name suggests, the parasites "settle down" in the liver and grow and develop.

The liver cysts we usually refer to are congenital liver cysts. Most liver cysts grow slowly and have no obvious symptoms for a long time or even for life.

two,

What symptoms may occur with liver cysts?

1

Gastrointestinal symptoms

When the cyst enlarges and presses on the stomach, duodenum, and colon, it can cause symptoms such as fullness after meals, loss of appetite, nausea, and vomiting.

2

Upper abdominal pain

It may cause upper abdominal distension, discomfort, dull pain or mild dull pain. If there is sudden severe pain or symptoms and signs of peritonitis, it indicates complications such as cyst bleeding or rupture, and chills and fever may occur.

3

Abdominal mass

Sometimes you may accidentally feel a mass in your abdomen.

4

jaundice

If the cyst compresses the hepatic duct or common bile duct, it may cause jaundice.

For simple liver cysts, regular follow-up with abdominal color ultrasound is required, generally once a year. When complications occur, such as cyst rupture, cyst pedicle torsion, intracystic bleeding, or a large cyst compressing adjacent organs and affecting eating, surgical treatment is required. In addition, some elderly and weak patients who cannot tolerate surgery can choose to undergo liver cyst puncture and fluid extraction under the guidance of abdominal ultrasound examination combined with anhydrous ethanol injection or sclerosing agent treatment.

In general, the prognosis of liver cysts is good. It is not a terminal illness as people imagine and can be cured through treatment.

three,

In what cases do liver cysts need to be treated?

1

Giant liver cyst

A small number of liver cysts grow rapidly. When the diameter of the cyst exceeds 10 cm, it is medically called a giant liver cyst. Giant liver cysts can easily cause compression symptoms, which will affect the patient's life and work, and should be actively treated. There are two main treatment methods: one is liver puncture to extract fluid, that is, under the guidance of ultrasound, use a fine needle to extract the fluid in the cyst, and then inject alcohol or a hardener to prevent the cyst from growing. The second is the "roof-off" surgery of the liver cyst, that is, after the cyst fluid is sucked out, most of the cyst wall or all the free cyst wall is removed, just like removing the roof of a house. In addition, liver cyst surgery can also be performed under laparoscopy.

2

Secondary infection of cyst

When liver cysts are secondarily infected, patients may experience inflammatory symptoms such as pain in the liver area, fever, and increased white blood cell count, and anti-infection treatment should be carried out in a timely manner.

3

Bleeding secondary to cyst

In a few cases, the blood vessels in the cyst wall of liver cysts may rupture spontaneously, leading to intracystic bleeding. Some patients have no obvious symptoms, while others experience severe pain in the liver area, which is similar to acute abdomen. If conservative treatment is ineffective, surgical treatment should be performed.

4

Cyst torsion

When a pendulous liver cyst twists, the patient will experience severe abdominal pain and surgery may be the only treatment. This is a very rare phenomenon.

Four,

How to prevent liver cysts?

Although liver cysts are not serious, they cannot be ignored. We should pay special attention to the following points in our daily life.

1

Eat healthy

In your daily diet, focus on low-fat and easily digestible foods to reduce the fat content and total calories in your food. Eat more fresh vegetables and fruits, and reduce spicy, irritating, and greasy foods to avoid increasing the burden on your liver.

2

Quit smoking and drinking

The harm of tobacco and alcohol to the human body is obvious to all. Especially alcohol, which is extremely harmful to the liver. If liver cysts occur, alcohol will also promote the growth of cysts and cancer.

3

Pay attention to hygiene

Avoid accidentally ingesting hydatid eggs which may lead to parasitic liver cysts.

4

Do not abuse medication

The probability of chronic hepatitis patients suffering from liver cysts is 100 times higher than that of normal people. To prevent liver cysts, ordinary people must first prevent infection with hepatitis B and hepatitis C viruses. Pay special attention to medication safety. Many drugs may cause liver damage and should not be taken indiscriminately, such as antibiotics, painkillers, contraceptives, hypoglycemic and lipid-lowering drugs, etc.

5

Regular medical check-ups

If you are in a high-risk group or find that your liver cyst is large, it is recommended that you have regular physical examinations, usually with an ultrasound every six months or a year, to observe changes in the liver cyst.

Text/Fat Bear Picture/Internet (Please contact to delete) Review/Ultrasound Medicine Department Hepatobiliary and Pancreatic Tumor Center

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