What is Liver Cystic Disease?

Hepatic cysts (HCs) are a common issue that doctors specializing in digestion and liver conditions often handle. Hepatic cysts are abnormal, small pockets filled with fluid that grow within the liver. They typically develop from liver cells, bile duct cells, connective tissue, or even metastases – spread from other organs outside the liver. These cysts may contain either fluid or solids. Mostly, liver cysts are detected unexpectedly during imaging studies for other conditions, and they usually do not pose severe health risks. They often don’t cause symptoms and are rarely linked to life-threatening conditions. In fact, before diagnostic imaging technology came along, hepatic cysts were usually found during surgery. The most common type of hepatic cysts are simple cysts. They are fairly common, affecting 15-18% of people in the United States and 5 to 10% of people worldwide.

In most cases, these liver cysts can be monitored and do not require any treatment. However, a small number of these cysts might grow large enough to cause symptoms, requiring medical attention or even surgery.

The process of diagnosing liver cysts considers a wide range of possible causes, including infection, inflammation, tumors, birth defects, and injuries. This article focuses on the general understanding, causes, diagnosing, symptoms, and treatment options for different typical primary liver cysts, rather than diagnosing and managing spread-out cysts, infection-related cysts, and Hepatocellular carcinoma – a type of liver cancer.

What Causes Liver Cystic Disease?

There are two general types of liver cysts which are known as Hepatic Cysts (HCs): infectious and non-infectious. The infectious ones can be due to harmless causes, growths (neoplastic), injuries (traumatic) or parasites like Echinococcus and hydatid cyst. Non-infectious liver cysts can be due to non-parasitic causes like bacterial (pyogenic) or fungal abscesses.

Simple cysts are the most common type and we’re not fully sure why they happen. Most of these cysts are present from birth and typically come from non-normal growth of bile ducts, the tubes that transport bile from the liver.

Polycystic Liver Disease (PCLD) is another condition where cysts form in the liver. Experts suggest two people get these cysts. The first is because of abnormal bile ducts that detach from the rest of the duct system and balloon to form cysts. The second suggestion is a problem with the tiny, hair-like cilia inside the bile ducts. This can lead to an overproduction of cholangiocytes, cells that line the bile ducts, and this can lead to cysts. Often, PCLD is congenital, meaning present from birth, and it mostly happens to people with Autosomal Dominant Polycystic Kidney Disease (ADPKD), a genetic disease caused by changes or ‘mutations’ in specific genes (PKD1 and PKD2).

While PCLD usually goes hand in hand with ADPKD, there have been instances where PCLD was found alone. This was first reported as a separate disease in 1950 and confirmed genetically in 2003. Two different genes have usually been found to be changed in these cases (PRKCSH and SEC63).

In the more severe version of the disease known as Autosomal Recessive Polycystic Kidney Disease, the patient usually dies quickly after birth due to lung complications. Those who survive usually have liver scarring (fibrosis) rather than cysts.

To classify these types of liver cysts, doctors use something called Gigot Criteria or Qian’s classification system. The Gigot Criteria is based on imaging tests, with three types, depending on the number and size of the cysts and how much of the liver is involved. On the other hand, Qian’s classification, used mainly for screening family members, is based on the number of cysts and defines five grades, from no cysts up to more than 20 cysts and a noticeable increase in liver size due to disease.

Lastly, biliary cystadenoma is a type of slow-growing growth that arises from the bile ducts. The exact cause is still unknown. It could be due to an injury and subsequent recovery process or maybe due to abnormal development from birth. Biliary cystadenocarcinoma is another type of growth arising from the bile ducts and distinguishing it from biliary cystadenoma can be done through patient information, liver tests, tumor size and presence of other growths. However, there is no absolute reliable way to tell them apart and precise diagnosis is often made after surgery.

Risk Factors and Frequency for Liver Cystic Disease

Hepatic cysts (HCs) are seen in about 3 to 5% of the population using ultrasound, and 15 to 18% using CT scans. Simple cysts, the most common liver condition, have a prevalence of 2.5 to 5% in the population. They are usually diagnosed in people over 40, more frequently in women (at a ratio of 4 to 1), and their prevalence increases with age.

Isolated Polycystic Liver Disease (PCLD) affects 1 to 10 out of every million people. Autosomal Dominant Polycystic Kidney Disease (ADPKD) is seen in 1 out of every 400 to 1 in 1,000 people. ADPKD accounts for 80 to 90% of all PCLD. Both men and women have the same risk of developing Isolated PLCD due to its inheritance pattern. However, women are more commonly affected than men (at a ratio of 6 to 1), which is likely due to higher estrogen levels in women.

The risk factors for severe PCLD include age, being female, use of external estrogen, multiple pregnancies, and significant kidney involvement in ADPKD.

  • Hepatic cysts (HCs) are seen in 3 to 5% of the population on ultrasound, and 15 to 18% on CT scans.
  • Simple cysts, the most common liver condition, affect 2.5 to 5% of the population.
  • They are usually diagnosed in people over 40, more commonly in women at a ratio of 4 to 1.
  • The frequency of these cysts increases with age.
  • Isolated Polycystic Liver Disease (PCLD) affects 1 to 10 out of every million people.
  • Autosomal Dominant Polycystic Kidney Disease (ADPKD) affects 1 in 400 to 1 in 1,000 people.
  • ADPKD makes up 80 to 90% of all PCLD cases.
  • Both men and women have the same risk for Isolated PLCD, but women are more commonly affected at a ratio of 6 to 1.
  • Age, being female, using external estrogen, having multiple pregnancies, and significant kidney involvement in ADPKD are risk factors for severe PCLD.
    • Rare conditions, Biliary Cystadenomas (BCAs) and Biliary Cystadenocarcinomas (BCACs), make up a small percentage of HCs worldwide. BCAs comprise 1 to 5% of HCs and considered the most common liver tumour. They are usually found in middle-aged women (9 to 1 ratio compared to men), between 40 and 50 years old. They grow slowly and can grow up to 30 cm. There’s a 30% chance they can become malignant, turning into BCACs. They are commonly found in the right liver lobe.

      • Biliary Cystadenomas (BCAs) and Biliary Cystadenocarcinomas (BCACs) are rare conditions that make up a small percentage of HCs worldwide.
      • BCAs comprise 1 to 5% of HCs and are the most common liver cystic tumour.
      • These are usually found in middle-aged women (9 to 1 ratio compared to men), between 40 and 50 years old.
      • They can grow very slowly to a large size, up to 30 cm.
      • There’s a 30% chance they can become malignant, turning into BCACs.
      • They are most often found in the posterior segment of the right liver lobe.

      Signs and Symptoms of Liver Cystic Disease

      When a person comes in for a medical evaluation, there can be a lot of important factors to consider, like the person’s age, gender, and other big-picture things like their medical history or any relevant travel history. Even whether or not they’re using hormone-based birth control or have a past of chronic liver disease might offer important clues as to what’s going on.

      When looking specifically at hepatic cysts, many people have no issues at all. However, a small group of people may experience less comfortable conditions like a dull ache in the upper right part of the stomach, feeling full early into meals, experiencing nausea or vomiting, or even getting out-of-breath easily. These symptoms can come from the size of the cyst in the liver. In less common cases, the cyst can get so big that it’s able to be felt during a physical exam and can lead to serious health issues.

      Other complications from hepatic cysts could also include bile duct blockages (which can cause jaundice and itching), the cyst bursting (which can lead to symptoms similar to liver abscesses or bacterial peritonitis), or the cyst causing a sudden acute abdominal pain.

      One other thing doctors will look for is a history of multiple liver cysts in the family. This could point to conditions like ADPKD (Autosomal Dominant Polycystic Kidney Disease) or PCLD (Polycystic Liver Disease). In those cases, the cysts could make the liver larger and harder than normal (hepatomegaly), but this is not common. Far less often, those with liver cysts can experience issues with blood flow in the liver, which leads to liver failure, portal hypertension, and upper GI bleeding. Some might even have a condition similar to Budd-Chiari syndrome, where blood can’t leave the liver properly.

      In rare cases, a person with PCLD might experience a recurring exudative pleural effusion on the right side (fluid building up around the lungs).

      When we’re talking about ADPKD, those patients can have cysts in the kidneys, but also in other places too. These can be things like cysts in the brain or pancreas, heart valve diseases, diverticula in the colon, hernias in the abdomen or inguinal region, or cysts in the seminal vesicles.

      Finally, when talking about Biliary Cystadenoma (BCA) or Biliary Cystadenocarcinoma (BCAC), their symptoms are often quite similar. BCACs can spread into the nearby bile ducts, while BCAs, which grow quite slowly, can end up causing compression in the bile ducts.

      Testing for Liver Cystic Disease

      Typically, liver function tests along with renal function tests, which include blood urea nitrogen (BUN) and creatinine levels, are valuable tools in the diagnosis of hepatic cysts. While most patients show normal results, some may have mild elevations in liver enzymes. Abnormally high levels of certain enzymes like alkaline phosphatase and gamma-glutamyl transferase might be present. Other elements such as carcinoembryonic antigen (CEA) and CA 19-9 could also be elevated. CA 19-9 is useful as a diagnostic or follow-up marker as it’s present in the internal lining of simple cysts.

      Doctors have several options for imaging the liver in patients with liver cysts. Ultrasonography is a common, non-invasive tool that doesn’t involve harmful radiation. It’s beneficial in differentiating between simple and complex cysts. CT scans, while possibly harder to interpret, provide highly detailed images of the cysts and can be valuable in treatment planning. Other imaging methods like MRI, hepatic angiography, and nuclear medicine scanning play a smaller role in diagnosing liver cysts.

      In ultrasound images, simple liver cysts appear as clear, uniform, non-divided, thin and smooth compartments with enhanced sound waves at the back. Yet, a simple cyst that has experienced bleeding can confuse these findings. On CT scans, these cysts show up as clearly defined, low-density lesions that do not become highlighted after applying intravenous contrast.

      Liver and kidney ultrasound is recommended initially to identify cysts. Yet, distinguishing between Polycystic liver disease and Autosomal Dominant Polycystic Kidney Disease (ADPKD) can be difficult due to the presence of cysts in both cases. Therefore, ADPKD should be excluded before diagnosing isolated Polycystic liver disease. Meanwhile, patients with ADPKD should have periodic evaluations every 3 to 5 years for cerebral aneurysm.

      In special cases, cysts with irregular characteristics may need to be evaluated via CT or MRI scans for possible malignant or infectious causes. Cysts that are suspected to be cancerous can be slowly growing, single, divided, and filled with clear, mucus-like fluid. The presence of internal fragments, bile duct expansion, and enhancement of mural nodularity necessitates an evaluation for Biliary Cystadenocarcinomas (BCACs).

      Biopsy and histological findings remain the final confirmation for Biliary Cystadenoma (BCA) diagnosis and differentiating from BCAC. Yet, this is usually done following surgical resection. Aspirating the contents of the cyst is rarely used to make the diagnosis, as they have a typical appearance on ultrasound. In simple cysts, the fluid removed is typically sterile. Sometimes, high levels of carcinoembryonic antigen in the cyst may hint at invasive carcinoma.

      Regarding genetic testing, Polycystic liver disease follows a pattern where there is a 50% chance of the disease recurring in the next generation. However, as it doesn’t affect management, genetic testing is not a routine procedure, although it could be considered for patients with a family history of ADPKD or Polycystic liver disease. Screening for mutations of the genes causing ADPKD or Isolated Polycystic liver disease can confirm the clinical diagnosis. Yet, due to the disease’s low prevalence, it’s not recommended to screen the disease in the general population.

      Treatment Options for Liver Cystic Disease

      If you have a simple cyst that’s not causing any symptoms, it generally doesn’t need treatment besides regular check-ups. These check-ups often involve ultrasound scans that are done every 3 to 12 months. If the cyst remains the same size, there’s no need for further follow-up. Some cysts even go away by themselves without any treatment needed.

      However, if you’re experiencing symptoms, or the cyst is growing larger, there might be a concern that it could be a tumor. Various treatments including draining the cyst with a needle, removing part of the liver, or using chemicals to reduce the size of the cyst might be necessary. A laparoscopic approach (a procedure using small incisions and a camera to guide the surgeon) is the current standard of care. However, studies have found that recurrence, or the cyst coming back, can vary from 4% to 41% after laparoscopic surgery.

      Polycystic liver disease focuses on reducing the size of the liver. Different approaches include medications that have shown positive results, such as octreotide, sirolimus, and estrogen receptor antagonists. Studies also show that tolvaptan, which blocks a specific receptor, can slow down cyst development and growth.

      For surgical therapy, percutaneous cyst aspirations (draining fluid from the cyst with a needle) followed by sclerotherapy (injection of a substance into the cyst to shrink it) can be done. Laparoscopic cyst fenestration, which is a procedure to remove part of the cyst, can also be an option. In certain cases, partial removal of the liver or even a liver transplant might be necessary, especially if other treatments are not feasible.

      If the cyst is neoplastic, meaning it could potentially turn into cancer, it’s typically recommended to remove it through surgery. This is due to the risk of the cyst becoming malignant (cancerous) and recurring. Monitoring the level of a specific protein, CA 19-9, in your blood regular intervals can help determine whether the treatment was successful.

      There are several non-infectious and neoplastic conditions, as well as infectious and traumatic ones that involve cystic liver lesions. Here are some of them:

      Non-infectious benign conditions:

      • Biliary Hamartomas (also known as von Meyenburg complexes): These are rare, benign lesions that are usually present at birth and typically have no symptoms. These don’t need any treatment.
      • Caroli Disease: This is a rare condition that causes cysts to develop in the bile ducts of the liver. People with this disease may experience frequent infections and other complications related to the liver. Possible treatments range from conservative approaches to surgery or even a liver transplant in severe cases.
      • Intrahepatic Pseudocyst: This generally occurs as a result of alcohol-related pancreatitis. It may warrant immediate treatment through draining or even surgical removal if the pseudocyst is large or causing symptoms.
      • Cavernous Hemangioma: These benign tumors consist of clusters of blood-filled cavities inside the liver. They’re usually not a cause for concern and simply need to be monitored through regular imaging studies.

      Neoplastic conditions:

      • Cystic Liver Metastases: If your doctor finds multiple cystic lesions within your liver, it may indicate that cancer has spread to your liver from another part of your body. The symptoms and ultrasound findings will depend on the primary location of the cancer.
      • Undifferentiated Embryonal Sarcoma: This is an aggressive type of liver cancer that usually affects children aged between 6 to 10 years. Treatment often involves surgical resection and chemotherapy.
      • Intraductal Papillary Neoplasms of the Bile Duct: Although these tumors are rare, they require attention as they often lead to recurrent bouts of cholangitis and obstructive jaundice.

      Traumatic conditions:

      • Biloma: This typically occurs after abdominal surgery or due to a blunt abdominal injury and results in a collection of bile outside the biliary tree.
      • Hematoma: This is usually a consequence of a blunt abdominal trauma and makes up the second most common type of abdominal injuries.

      Infectious conditions:

      • Hydatid Cyst: These cysts may cause pain as they grow, and complications can arise if they rupture. Usually, they’re diagnosed incidentally and treatment involves surgical removal.
      • Hepatic Abscesses: Patients with hepatic abscesses often present with symptoms like abdominal pain, fever, and a high white blood cell count. Different types of hepatic abscesses are caused by different conditions and have slightly different symptoms and treatments.

      What to expect with Liver Cystic Disease

      A simple cyst, which is a fluid-filled sac, typically has a good outcome and is tracked with imaging studies like MRI or CT scans. After surgery to remove the cyst, usually, no further treatment is needed unless the patient starts having symptoms, or there’s a high chance of the cyst coming back.

      Isolated PCLD (Polycystic Liver Disease) generally has a less serious outlook compared to ADPLD (Autosomal Dominant Polycystic Liver Disease) and usually doesn’t cause symptoms. The main goal of treating PCLD is to reduce the size of the liver. Although, surgical procedures for this can pose a high risk of serious side effects. Despite this risk, it’s important to measure these potential side effects against the benefits of surgery. Extremely enlarged livers can eventually lead to end-stage liver disease, where the liver stops working altogether.

      Liver failure can occur in the late stages of liver disease and is often discovered by accident. The size of the liver can predict the prognosis and how it can affect a patient’s quality of life. In terms of liver disease, medical professionals use the MELD Score to predict the short-term survival of patients with liver failure, and it helps decide who should get a liver transplant. In patients with PCLD, the liver still functions so this score won’t increase.

      Patients with PCLD who carry specific mutations in their PRKCSH or SEC63 genes potentially can have a more severe disease progression than patients without these mutations. Also, patients with mutations in the PKD2 gene have a better kidney prognosis than those with mutations in the PKD1 gene.

      For BCA (Bile Duct Cancer) and BCAC (Bile Duct Adenocarcinoma), there’s a limited understanding of what factors impact the prognosis following the surgical removal of these cancers because they are quite rare. However, the overall outlook is generally better than other malignant liver tumors. Some research has shown that a complete surgical removal of the tumor can result in a recurrence rate of only 5% to 10%.

      Possible Complications When Diagnosed with Liver Cystic Disease

      : Larger cysts in the body, particularly those found in the liver, are more likely to cause severe symptoms and complications.

      Some reported issues include:

      • Excessive bleeding (hemorrhage)
      • Cyst rupture, which can happen after a traumatic event
      • Bile duct torsion
      • Secondary infection
      • Compression of the biliary tree, which is part of the body’s bile production system
      • Malignant transformation, or cancer development, particularly in cystadenoma cases
      • Severe allergic reaction (anaphylactic shock) due to hydatid cysts

      There also some unusual complications such as Budd-Chiari syndrome, which is caused by a fast-growing cyst blocking the liver’s vein. There’s also a case involving a blood clot in the major vein carrying blood from the lower half of the body to the heart (inferior vena cava), caused by external pressure from a simple liver cyst.

      On the other hand, liver failure is a rare condition that may occur in patients with isolated PLCD, which is a type of liver disease. If a patient has ADPKD, a kidney disease, alongside this, they can also experience manifestations elsewhere in the body. These could include:

      • Brain aneurysms
      • Pancreatic cysts
      • Cardiac valve disease
      • Diverticula, or small pouches, formed in the colon
      • Abdominal wall and inguinal hernia
      • Seminal vesicle cyst

      These conditions should be evaluated if present.

      Preventing Liver Cystic Disease

      People often get worried when they find out they have a liver mass because they’re scared it might be cancer. Luckily, most liver masses are things called incidentalomas, which are usually harmless and just need to be monitored. Your doctor might reassure you if this is the case. It’s key to understand though, that these harmless liver masses – known as simple hepatic cysts – could potentially bleed, particularly if you’re taking certain medication that thins your blood, like anticoagulation drugs.

      If you’ve been diagnosed with PCLD, a genetic disease which causes cysts to grow in the liver, your doctor might advise you to stop using extra estrogen, and to consider other ways to prevent pregnancy. Because this type of cyst disease runs in families, your relatives might be advised to get regular check-ups and possibly genetic testing, to see if they carry the gene for PCLD.

      For those who are both affected by and at high risk of a kidney disease called ADPKD, the best advice is to live a healthy lifestyle. You could consider limiting dairy proteins, keeping your weight healthy, cutting down on salt, doing regular aerobic exercise, giving up caffeine, quitting smoking, and reducing the use of pain-relief drugs (known as non-steroidal anti-inflammatory agents), as well as ACIs and ARBs, which are medications for heart conditions and high blood pressure. It’s worth noting that being overweight or obese can make this kidney disease worse, specifically decreasing the GFR – a measure of kidney function – and increasing the size of kidneys.

      If you have BCA, a condition which can grow in your liver’s bile duct, it’s important to know that you could be at a high risk of these growths becoming cancerous. Your doctor will likely explain the need to fully remove these growths to prevent further health problems.

Frequently asked questions

Liver cystic disease refers to the presence of abnormal, small pockets filled with fluid that grow within the liver. These cysts can develop from liver cells, bile duct cells, connective tissue, or even metastases from other organs. They are usually detected unexpectedly during imaging studies and often do not pose severe health risks. Most liver cysts are simple cysts, which are fairly common and do not require treatment in most cases.

Liver cystic disease is seen in about 3 to 5% of the population using ultrasound, and 15 to 18% using CT scans. Simple cysts, the most common liver condition, affect 2.5 to 5% of the population.

Signs and symptoms of Liver Cystic Disease can vary depending on the size of the cyst and the individual. Some common signs and symptoms include: - Dull ache in the upper right part of the stomach - Feeling full early into meals - Nausea or vomiting - Easily getting out-of-breath - Enlarged liver (hepatomegaly) - Jaundice and itching (caused by bile duct blockages) - Sudden acute abdominal pain - Recurring exudative pleural effusion on the right side (fluid building up around the lungs) in rare cases of PCLD - Issues with blood flow in the liver, leading to liver failure, portal hypertension, and upper GI bleeding in some cases - Compression in the bile ducts caused by Biliary Cystadenoma (BCA) - Spread into nearby bile ducts by Biliary Cystadenocarcinoma (BCAC) It is important to note that many people with hepatic cysts may not experience any symptoms at all. However, if any of these symptoms are present, it is recommended to seek medical evaluation and guidance. Additionally, a history of multiple liver cysts in the family may indicate underlying conditions like ADPKD or PCLD.

Liver Cystic Disease can be acquired through various causes such as infectious factors, non-infectious factors, abnormal bile ducts, abnormal development from birth, and genetic diseases like Autosomal Dominant Polycystic Kidney Disease (ADPKD).

The doctor needs to rule out the following conditions when diagnosing Liver Cystic Disease: 1. Biliary Hamartomas (von Meyenburg complexes) 2. Caroli Disease 3. Intrahepatic Pseudocyst 4. Cavernous Hemangioma 5. Cystic Liver Metastases 6. Undifferentiated Embryonal Sarcoma 7. Intraductal Papillary Neoplasms of the Bile Duct 8. Biloma 9. Hematoma 10. Hydatid Cyst 11. Hepatic Abscesses

The types of tests that are needed for Liver Cystic Disease include: - Liver function tests - Renal function tests (including blood urea nitrogen and creatinine levels) - Enzyme tests (such as alkaline phosphatase and gamma-glutamyl transferase) - Carcinoembryonic antigen (CEA) test - CA 19-9 test - Ultrasonography - CT scans - MRI scans (in special cases) - Biopsy and histological findings (usually done following surgical resection) - Genetic testing (for patients with a family history of ADPKD or Polycystic liver disease)

Liver Cystic Disease can be treated in various ways depending on the specific circumstances. If the cyst is simple and not causing any symptoms, regular check-ups and ultrasound scans every 3 to 12 months may be sufficient. Some cysts may even go away on their own without any treatment. However, if symptoms are present or the cyst is growing larger, treatments such as draining the cyst with a needle, removing part of the liver, or using chemicals to reduce the size of the cyst may be necessary. A laparoscopic approach is the current standard of care, but recurrence after surgery can vary. For Polycystic liver disease, medications like octreotide, sirolimus, estrogen receptor antagonists, and tolvaptan can be used to reduce the size of the liver and slow down cyst development. Surgical options include percutaneous cyst aspirations followed by sclerotherapy, laparoscopic cyst fenestration, partial removal of the liver, or even a liver transplant in certain cases. If the cyst is neoplastic, surgery is typically recommended to remove it due to the risk of it becoming cancerous. Monitoring the level of CA 19-9 protein in the blood can help determine the success of the treatment.

The side effects when treating Liver Cystic Disease can include: - Excessive bleeding (hemorrhage) - Cyst rupture, which can happen after a traumatic event - Bile duct torsion - Secondary infection - Compression of the biliary tree, which is part of the body's bile production system - Malignant transformation, or cancer development, particularly in cystadenoma cases - Severe allergic reaction (anaphylactic shock) due to hydatid cysts There are also some unusual complications such as: - Budd-Chiari syndrome, caused by a fast-growing cyst blocking the liver's vein - Blood clot in the major vein carrying blood from the lower half of the body to the heart (inferior vena cava), caused by external pressure from a simple liver cyst In addition, patients with isolated PLCD (a type of liver disease) and ADPKD (a kidney disease) may experience manifestations elsewhere in the body, including brain aneurysms, pancreatic cysts, cardiac valve disease, diverticula formed in the colon, abdominal wall and inguinal hernia, and seminal vesicle cyst. These conditions should be evaluated if present.

The prognosis for Liver Cystic Disease varies depending on the specific condition: - Simple cysts, which are fluid-filled sacs, typically have a good outcome and may not require treatment unless they cause symptoms or have a high chance of recurrence. - Isolated Polycystic Liver Disease (PCLD) generally has a less serious outlook compared to Autosomal Dominant Polycystic Liver Disease (ADPLD) and usually doesn't cause symptoms. The main goal of treating PCLD is to reduce the size of the liver, but surgical procedures for this can pose a high risk of serious side effects. - Biliary Cystadenomas (BCAs) and Biliary Cystadenocarcinomas (BCACs), which are rare conditions, have a generally better prognosis than other malignant liver tumors when surgically removed, with a recurrence rate of only 5% to 10%.

A doctor specializing in digestion and liver conditions should be consulted for Liver Cystic Disease.

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