Rare cystic liver lesions: A diagnostic and managing challenge

Figure 1 Ultrasound image. A: Showing an anechoic mass in the liver (light blue arrow), with a rather thin capsule (cystadenoma); B: Showing two echinococcal cysts. The first on the right (red arrow-right image) appears as an anechoic mass with hydatid sand (type CE1) (white arrow-right image), while in the second (on the left), the detached and folded endocyst membrane is obvious (type CE3) (white arrow-left image).

Figure 2 Computed tomography image. A: In liver segment IV there is a large cystic lesion (black arrow) causing compression with dilatation of biliary ducts (light blue arrows) in the left liver lobe. Peripheral contrast enhancement (light green arrow) as well as a nodule (pink arrow) is evident in this case of cystadenoma; B: Echinococcal disease evaluated. Two lesions are evident. The first in liver segment I appears as a multilocular cystic lesion (black arrow) and the second in liver segment VI as a calcified mass with irregular margins (white arrow); C: Demonstrates direct infiltration of a liver hydatid cyst in the adjacent peritoneal surface and abdominal wall (light blue arrow); D: A typical case of multicystic disease with liver (light blue arrow) and kidney (pink arrow) involvement were very well depicted; E: Showing two large cystic-appearing liver lesions (light blue arrows) in a case of a metastatic pancreatic cystadenocarcinoma that is also evident (pink arrow); F: A large cystic lesion (light blue arrow) with a small solid component at the periphery (pink arrow), as well as two small hypodense liver lesions (black arrows), are seen on this image, in a case of proven gastrointestinal stromal tumors metastatic lesions.

Figure 3 Magnetic resonance T1-w image shows an echinococcal cyst as a multiloculated cystic liver lesion, indicative of the presence of daughter cysts (light blue arrow). A second smaller unilocular lesion with peripheral contrast enhancement is also seen (pink arrow).

Figure 4 Image. A: Computed tomography image in a case of multicystic disease, showing two large dominant cysts causing mild intrahepatic biliary dilatation (black arrows); B: Magnetic resonance cholangiopancreatography image shows multiple hepatic cysts (light blue arrows) while the common bile duct seems compressed between the two larger cysts (black arrow).

Figure 5 A case of Caroli disease. A: On computed tomography. A large intra-biliary stone (black arrow) is evident in the dilated ducts (red arrows); B: On magnetic resonance imaging. A large intra-biliary stone (pink arrow) is evident in the dilated ducts (blue arrows).

Figure 6 Liver cystic lesions management algorithm.