Liver cyst - am so worried

[carina62]

I had an ultrasound scan last week for possible gallstones, no gallstones were found but the scan showed up I have a liver cyst and now my doctor is referring me to a specialist.  Why is he referring me if he doesn't think it's anything to worry about?  I am in panic mode.

[Beveroni]

Hello how was MRI scan? How are you ? I'm waiting on a similar thing

[nasirul]

Thank you for taking the time to reply to me and I will take your suggestion

[carina62]

My appointment for my MRI scan has come through and it's for next week.  Am feeling rather nervous but relieved at the same time.

[carina62]

hello, while I am waiting for my MRI scan appointment, I have another question about my complex cyst.  I don't know how long I have had it, I don't know if it started as a 'simple' cyst and changed over time to a 'complex' one and I don't know if it will continue to change over time (I guess these are also questions for the Consultant).  I do feel angry though that this was only picked up during an ultrasound scan for something else (ie gallstones) and it makes me wonder if I had taken the responsibility myself and decided to have annual regular scans whether I could have 'nipped it in the bud' so to speak.

[carina62]

hello Livelife777.  Thank you for taking the time to reply to me and I will take your suggestion and contact the person you mention above.  Any advice etc is most welcome.

[carina62]

hello thank you to all of you who have taken the time and trouble to listen to me and to reply back to me.  I think I am doing all I can at the moment and until I have my MRI I won't know anymore but I will keep you posted on how I get on and if I have anymore information I will let you know.  I have to admit that I don't feel 'comfortable' having this cyst inside me (and especially in my liver) but it has now been detected and is now being acted on so I cannot do much more.  I will await the consultant's instructions on how to proceed next and of course will go armed with lots of questions for him.  Take care yourselves too.

[fntn]

As you've already read in your report, just about everything is normal. So this of course is great and matches your normal blood work as well. And your cyst is noted as being echo-free which simply means there isn't anything solid to bounce the sonic waves back. This is perfectly normal for a cyst since they are typically filled with just fluid.

But the radiologist also mentions "irregular outline containing thin septations". And it's this that causes your cyst to be considered complex vs simple. But these deviations can be caused by benign things - the septa maybe due to blood, pus, etc. Your doctors will likely have the needed data after your MRI so we'll have to wait and see what the final conclusions are.

The cyst in your kidney is common as well. I have two in my remaining kidney now. They appear and disappear on their own and typically without any noticeable symptoms. Problems don't arise until they begin to show up in greater numbers - as in polycystic kidney disease.

[Livelife777]

Good Evening Carina.   I want you to know that I'm not a Dr and can only share with you my opinions.  Your Dr obviously is the person to ask how to move forward as he is the expert.                                                                       I did a bit of reading on complex cysts and can only give you my impression and interpretation.  Typically simple tumor cysts are benign and complex are usually also, but somewhat more complicated.  You definitely need to follow up this diagnosis as in rare cases it could be worrisome.  You actually have some good news now as your tumor markers and liver enzymes look good.

If I were in your shoes I would see a specialist (Hepatologist) and get the MRI just to be on the safe side.  You need to do this for your own piece of mind.  They may decide to wait and watch, biopsy it, or remove it depending on the imaging results.  Usually we are not aware of having a cyst unless it becomes problematic which may be what you've been experiencing.
Perhaps I'm approaching this cautiously as I had a lump in my Breast 10 years ago which the Drs felt certain from its characteristics that it was nothing.  They wanted me to rescan in 6 months which I refused and told them to surgically take it out.  It was Cancer!  
All indications point to this being simply a cyst, but I would request a more thorough investigation if it were me.

If you go to the top right corner of this page there is a search box with a looking glass in it you can type in Complex Cyst on the liver.  While doing some research in medical texts Medhelp came up with some info on this topic.  A gentleman named HectorSF answered some questions relating to this discussion.  He is beyond brilliant when it comes to anything related to liver disease and suggested to the poster to take action.  I respect his valued opinion and for this reason I am suggesting you take his comments to heart.

I'm sorry that I can't give you a definite answer but would be remiss if I only speculated regarding your health.  Please keep us posted on what you decide to do as we all do care.
~Kim

[carina62]

I collected my ultrasound scan report from the doctor's today and this is what the report says.  I would like feedback on this please, thanks:-

The liver is normal in size with increased in parenchymal echogenicity suggestive of fatty infiltration.  There is an echo-free cyst with irregular outline containing thin septations noted in the left lobe measuring 31 x 30mm.  No other focal lesion seen.  Normal antegrade flow was present in the portal vein.  The pancreas and spleen were unremarkable.  The gallbladder is well distended and appeared thin walled.  No gallstones seen.  The intrahepatic ducts and CBD are not dilated.  The aorta appears normal in calibre.  Both kidneys appear normal in size and echopattern.  No calculi or hydronephrosis seen.  The right kidney measures 129mm in biopolar length.  The left kidney measures 112mm in biopolar length with a simple cyst noted in the upper pole measuring 21mm.

Conclusion: Fatty liver with a complex cyst seen in the left lobe.  Left renal cyst.

What are your thoughts on this report?  Is it of big concern?

[fntn]

Given that you now have two different serum assessments spanning several months that show normal liver activity and function, I would be reassured that whatever is going on isn't aggressive. And cysts are known to very likely be benign which is consistent with this. As for liver tumor markers, they'll likely be measurng AFP, CEA and CA19-9. And as Kim mentioned, minor fluctations are not always worrisome since many different benign causes may trigger elevations. That the tricky thing about dealing with tumor markers, knowing when they are truly telling the doctor sometime or not.

We'll be here for you so help is ready if needed. Take care.

[carina62]

Sorry I know I have already posted something above which I would appreciate any advice or comments on, but also wanted to say that all my blood tests (including tumour markers and AFP) have all come back normal which naturally I am very pleased about but I still do not feel I am 'out of the woods' just yet until I have had my MRI and see what consultant has to say but I would like to take some positivity out of all these tests that I am having done.  

[carina62]

Can you please tell me? What other blood test tumour markers are there?  Was wondering if the consultant is still not sure about my complex cyst after MRI what happens next?  Also, as far as I know about my complex cyst, there is a septation down the middle.  Can a complex cyst be benign?  Any response much appreciated.

[Livelife777]

Good Luck tomorrow.   Keep in mind the AFP is not 100% accurate typically unless it's on the very high end.  100s or more.
Stay strong!
.....Kim

[carina62]

I have asked for a print out of my ultrasound scan report although the doctor did go over the finding with me over the computer screen.  I am very nervous as tomorrow I should be getting some blood test results (some being tumour markers) and AFP test.   I hope the results will be a little reassuring for me.  By the way, I received my most recent blood test results including LFT and all has come back normal and have asked for a print out.

[fntn]

The US and CT imaging techniques have their strong points but MRI is considered to be the best at the charaterization of focal lesions. So combining this new data with your existing data, a conclusive diagnosis should be reached. Be sure to get a copy of the radiology report when it becomes available. There maybe additional info on it that your doctor doesn't review with you.

[carina62]

I have now received a letter today for an appointment to be arranged for me for an MRI scan.  I am OK about having this but is this to have a
more indepth look at the cyst do you think?

[carina62]

Thank you both for your comments.  I will try and get full report soon.  In the meantime my GP has ordered some more blood tests for me (some of which are tumour markers) as she is trying to reassure me as best she can while I wait to see the consultant as she knows how much I am worrying at the moment.  I will also be having an X-ray so am having lots of tests done.  I will post more info as soon as i get them.  Thanks for listening.

[Livelife777]

Typically if they felt it was Cancer they would not wait 8 weeks.  When they look at a scan it's usually somewhat evident if something is amiss.  As fntn has said posting your new info will help.
Cysts on the liver are not that unusual. Try not to worry if possible.  Know it's difficult but remember the odds are in your favor.
......Kim

[fntn]

Have they told you which type of complex cyst they believe it to be? Or if they have a differential diagnosis that they're working with? If you have the results of the imaging (radiology report), the data maybe helpful.

[carina62]

The more I am thinking about my problem the more I am worrying.  My symptoms (which I am not sure whether they relate to my complex liver cyst or my hiatus hernia) are pain under right rib, radiating to my back and upper back.  Trouble is I have suffered from gastric reflux for 12 years and have always put my symptoms due to reflux,  it is only since the last couple of months that my reflux started to worsen and then I got this pain under right rib that I started to think gallstones and prompted me to visit GP about it (I do recall though having right rib pain one night 7 months ago).  Makes me wonder if I hadn't had this recent scan, I would be unaware of this complex cyst in liver (although I am obviously getting symptoms so I probably would have gone back to doctor).  I need to know what has caused it, how long I've had it and how fast it has grown?  My father died of liver cancer at 77 but my GP doesn't think it's genetic but I wish I had got annual scans now but I do hope it is nothing serious but the waiting and worrying is not doing me any good.

[carina62]

Hello fntn, I will post my recent blood tests as soon as i get them.  What I am constantly wondering and worrying about is that I now know I have this complex liver cyst inside me, and do not know if this cyst will turn cancerous (if it hasn't done so already) and I have to wait 8 weeks to see a consultant about it, is this waiting approach acceptable? I don't know what else I can do.  I have tried to see if I could get a cancellation appointment but they don't have any.

[fntn]

Your numbers are nice and normal even though they are a bit old as you mentioned. But given these numbers, I wouldn't be alarmed. We can take a look at your newer numbers when you get them and hopefully we'll see the same nice numbers. I would think that if your cyst was causing stress to your liver, we'd already be noting something in these numbers and we don't. Take care.

[carina62]

hello, OK well although I am waiting for some blood test results from 23.4.15 my most recent ones are dated in 13.01.15 (I have to also mention that as part of my 6 monthly diabetic review, liver and kidney tests are done and they have always come back fine since I was diagnosed T2 in 2009, according to the doctors anyway).

My tests anyway based on 13.01.15 are as follows:-

serum albumin level 45g/L (35.0 - 50.0)
serum alkaline phosphatase level 92 iu/L (30.0 - 130.0)
serum alanine aminotransferase level 39 iu/L (2.0 - 53.0)
serum bilirubin level 10 umol/L (21.0)

My FBC seems to be OK and within range apart from the Eosinophil count which I did mention to my GP about this and she said it was just above range but not to be concerned as she would have been if it was in the hundreds but mine 0.67

I hope you can help give me some reassurance based on these but like I say, I am still waiting for results done a week ago.

thanks

[fntn]

Do you have any of your blood work numbers? If we know which one's are not normal, we maybe able to provide more insight. Liver enzymes, total & direct bilirubin, cbc stuff, etc.?