Recurrent liver cyst: Case report and literature review

Abstract

Introduction: Liver cysts are defined as cavities within the liver tissue, surrounded by a layer of epithelium and filled with liquid or semi-liquid contents. They are mostly asymptomatic and usually diagnosed by ultrasonography, CT or Mr diagnostics. Symptoms occur as a result of complications such as bleeding, rupture, infection or compression of the biliary tract. All liver cysts can be divided into (1) infectious and (2) non-infectious liver cysts. The most common non-infectious cysts are simple congenital biliary cysts. Case outline: We present a 74-year-old female patient. She had upper right abdominal pain and dyspepsia several weeks before the first examination. Abdominal ultrasound and CT verified a large simple cyst of the right lobe of the liver of about 14cm in size. She underwent minimally invasive surgery when a partial cyst resection was performed. Seven months later, abdominal ultrasound, Mr and MRCP verified a simple recurrent cyst in the right lobe of about 13cm in size with no communication with the biliary system. She underwent open surgery when pericystectomia cum omentoplastica was performed. The pathohistological result showed a benign biliary cyst. There was no recurrence at regular follow ups 12 months upon the procedure. Conclusion: There are many treatment modalities, and each one is accompanied by certain disadvantages. In recent years, conventional open surgical procedures have been replaced by minimally invasive surgical procedures. Laparoscopic surgery is the method of choice in carefully selected patients. Open conventional surgery is reserved for patients with giant cysts, recurrent cysts, deep intraparenchymal cysts, and right lobe subphrenic cysts.