[Single non-parasitic liver cysts]

Solitary non-parasitic cysts of the liver (NPHC) are rare. The incidence of NPHC on autopsy is 0.2% to 0.5% and on imaging from 2.5 to 4.6% of the population. They are more common in females than males. Congenital cysts can be solitary, multiple or involve the whole liver which is referred to as polycystic liver disease (PCLD). Post-traumatic, neoplastic and echinococceal cysts are acquired lesions. Imaging procedures (USS, CT, MRI) are essential in diagnosis of hepatic cysts. Further diagnostic procedures include cytological, bacteriological and biochemical analysis of cystic fluid. Cystography can exclude communication of the cyst with the ductal system. Serologic tests are used in hydatid disease and serum tumour markers (CEA, CA 19-9) are measured to aid in differential diagnosis of suspected neoplastic cysts. Various therapeutic methods are used in the treatment of solitary non-parasitic hepatic cysts. The simplest is percutaneous obliteration with, for example ethyl alcohol. Fenestration (deroofing) with excision of the cyst wall is increasingly more often performed laparoscopically. Conventional open deroofing is used exceptionally, mainly in complicated cases.