Abstract

Objective: To investigate the diagnostic and therapeutic approach for congenital solitary liver cysts, which are benign lesions of the liver encountered rarely in childhood.

Methods: Seven cases who were diagnosed with congenital solitary liver cyst between 1993-2012, were analyzed retrospectively in respect to age, sex, symptoms, diagnostic methods, therapeutic interventions and follow-up.

Results: Of the 7 cases with a median age of 6 months (10 days-48 months), 4 were females, 3 were males. Five of the cases had prenatal diagnosis. Four cases were asymptomatic, others were admitted with abdominal distension and respiratory distress (n=2), recurrent abdominal pain (n=1). Diagnostic studies used for imaging were ultrasonography (n=7), computed tomography (n=4), magnetic resonans cholangiopancreatography (n=3). The cysts located in hilus (n=2), right lobe (n=2), left lobe (n=2), right and left lobe (n=1) were simple cyst in 4, biliary cyst in 3 of the cases. Therapeutic interventions were total cystectomy (n=2), partial cystectomy (n=1), percutaneous catheterization (n=1), laparoscopic exploration and drainage (n=1), partial cystectomy and portoenterostomy after percutaneous catheterization (n=1), partial cystectomy after percutaneous catheterization (n=1). Follow-up with a median duration of 12 months (1 month-60 months) revealed that the cyst resolved (n=3), decrease in size (n=3) or was the same size (n=1) in the imaging studies of ultrasonography (n=7) and magnetic resonans cholangiopancreatography (n=1).

Conclusion: Congenital solitary liver cysts are generally asymptomatic in childhood. The big cysts and the ones connected to the biliary system could necessitate early intervention. Differential diagnosis from other liver pathologies is mandatory with the imaging studies. The type and the onset of the therapeutic management depends on the clinical signs, size, location and biliary connection of the cyst. Total or partial cystectomy, internal drainage techniques such as portoenterostomy, percutaneous catheterization are among therapeutic approaches.