[症例報告]A large nonparasitic liver cyst requiring surgical intervention : A case report

The case of a large nonparasitic liver cyst with a 9-year history of cyst recurrence after undergoing aspiration therapy in a 78-year-old woman is herein reported. Nine years prior to this admission, she underwent an operation for a hernia of the lumbar intervertebral disc. At operation, a large liver cyst was incidentally detected, and the cyst was aspirated at that time to relieve her abdominal pain. Five years after the initial therapy, she developed abdominal distension and pain. The patient again underwent cyst aspiration. Thereafter, she experienced a 4-year symptom-free period after the second cyst aspiration. On admission, an abdominal CT scan revealed a large simple cyst measuring 17×12×17 cm in size which occupied most of the right liver lobe extending down to the right lower quadrant. At laparotomy, a large cyst showed entensive fibrous adhesions to the adjacent viscera. Following lysis of adhesions and the evacuation of the cyst fluid, the cyst, which was bulging into the abdominal cavity, was almost totally excised (unroofing). She remained asymptomatic 5 months after discharge. The standard treatment for nonparasitic liver cysts currently consists of cyst aspiration and alcohol sclerotherapy. However, the long-term follow-up of cysts after aspiration is unknown. Therefore, at present, cyst recurrence after aspiration may require either cyst unroofing or a partial excision.
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