Liver Cysts
Liver cysts are common, benign fluid-filled sacs in the liver, usually found incidentally on scans. They typically develop from small bile duct irregularities present from birth and rarely cause symptoms. Most need no treatment, but very large cysts can occasionally cause discomfort or fullness in the upper abdomen.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
The Liver
The liver is a large organ located in the upper right part of the abdomen. It plays a vital role in metabolism, digestion, hormone regulation, detoxification, and nutrient storage. It is made up of soft tissue with a network of blood vessels and bile ducts running through it. On imaging, the liver normally has a smooth, uniform appearance.
Liver cysts are fluid-filled (and occasionally more complex) sacs that can develop within the liver tissue. They are very common, usually benign, and most people never know they have one unless it is found incidentally during a scan done for another reason.
Most liver cysts:
- Cause no symptoms
- Do not affect liver function
- Remain stable in size
- Do not increase the risk of liver cancer
Understanding Liver Cysts
Most liver cysts do not cause any symptoms at all and are discovered incidentally during an ultrasound, CT, or MRI scan done for another reason.When symptoms do occur, they are usually related to larger cysts (typically over 5–7 cm) pressing on nearby structures.
Possible symptoms include:
- A dull ache or feeling of fullness in the upper right abdomen
- Bloating or abdominal distension
- Early satiety (feeling full quickly)
- Nausea, particularly after eating
These symptoms are non-specific and can occur for many different reasons, so they are not necessarily caused by a liver cyst. Even when symptoms are present, most liver cysts are benign and manageable with monitoring or simple treatments.
Causes
Most simple liver cysts have no clear cause, but they’re more common in people over 40, in women, and in those with a family history of cysts. Most develop from minor bile duct changes present from birth and are harmless. Rarely, cysts occur as part of an inherited condition such as polycystic liver disease, or from specific infections like hydatid disease - both of which have distinctive features on imaging and are usually easy for specialists to identify.
Diagnosing Liver Cysts
Liver cysts are often found incidentally, meaning they are discovered when imaging is done for another reason.
A variety of imaging tests can be used to identify liver cysts and to assess them further when they have features that aren’t typical of a simple cyst. The main options are:
| Ultrasound | Ultrasound is usually the first test used to diagnose a liver cyst. It is quick, non-invasive, and highly accurate for identifying simple cysts. On ultrasound, a simple cyst appears as a thin-walled, fluid-filled structure with no internal debris. This helps distinguish it from more complex cysts or solid liver lesions. |
| CT scan | A CT scan may be recommended if a cyst doesn’t appear clearly simple on ultrasound. It offers a more detailed view of the cyst’s wall, structure, and any internal features, making it helpful for assessing cysts that look slightly unusual or need clearer definition. |
| MRI Scan | An MRI provides very detailed images and is especially useful when a cyst has features that aren’t completely typical on ultrasound or CT. It helps clarify whether a cyst is simple and harmless, and is mainly used for reassurance or to confirm uncertain findings. |
Next Steps
Most liver cysts don’t require any treatment at all. Simple cysts are harmless and usually stay stable over time, so monitoring is often all that’s needed. Treatment is only considered if a cyst is causing symptoms, growing significantly, or has features that make it appear more complex.
| Simple cysts | Usually do not require any treatment or follow-up. |
| Large & symptomatic cysts | - Percutaneous apiration with sclerotherapy: Fluid is drained with a needle and a sclerosing agent is injected to reduce recurrence. - Laparoscopic fenestration: A minimally invasive surgery in which part of the cyst wall is removed to prevent it refilling. |
| Complex cysts | If imaging shows your cyst to be complex, you may be referred to a hepatobiliary specialist for mangement. The cyst may require surgical removal. |
| Hydatid (parasitic) cysts | Require specialist infectious disease and surgical management. This may involve antiparasittc medication, plus drainage or surgery. |
Most liver cysts are benign and need no intervention, but appropriate assessment is essential to identify the less common cysts that require treatment or specialist input.
How can Lanthorn help?
Liver Ultrasound - £300
A liver ultrasound is the first-line test for assessing liver cysts. It can clearly show the size, number, and appearance of cysts, helping to distinguish simple cysts from those that may need closer evaluation. It is quick, safe, and non-invasive.
Additional imaging - From £450
If a cyst looks unusual or more detailed characterisation is needed, CT or MRI can provide a clearer picture of the cyst’s internal structure and surrounding anatomy. These scans help differentiate benign cysts from more complex or rare cystic lesions.
Liver Function Blood Test - £99
Blood tests that assess overall liver function can help provide a broader understanding of liver health. While liver cysts often do not affect liver function, these tests can help rule out other causes of symptoms and ensure that the liver is functioning normally.
