Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 14, 2006; 12(18): 2949-2954
Published online May 14, 2006. doi: 10.3748/wjg.v12.i18.2949
Successful aspiration and ethanol sclerosis of a large, symptomatic, simple liver cyst: Case presentation and review of the literature
Wojciech C Blonski, Mical S Campbell, Thomas Faust, David C Metz
Wojciech C Blonski, Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, United States and Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland
Mical S Campbell, Thomas Faust, David C Metz, Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, United States
Correspondence to: Dr. David C Metz, 3400 Spruce Street, 3 Ravdin Building, Gastroenterology Division, University of Pennsylvania Health System, Philadelphia, PA 19104, United States. david.metz@uphs.upenn.edu
Telephone: +1-215-6623541 Fax: +1-215-3495915
Received: March 13, 2005
Revised: March 28, 2005
Accepted: July 20, 2005
Published online: May 14, 2006
Abstract

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.

Keywords: Simple hepatic cyst; Alcohol sclerosis; Laparoscopic deroofing