Symptoms of Cysts
Cyst symptoms vary depending on their location, size, and whether they are complicated by infection, hemorrhage, or rupture, but typically include pain, swelling, and pressure sensations at the affected site.
Common Symptoms by Cyst Location
Liver Cysts
- Pain in the right upper quadrant, particularly when cysts are large (>8 cm) and compress surrounding structures 1
- Sudden, severe abdominal pain when cyst hemorrhage occurs (present in approximately 80% of hemorrhagic cases) 1
- Fever and elevated inflammatory markers when cysts become infected 1
- Acute abdominal pain if cyst rupture occurs, which is a rare but serious complication 1
Pericardial Cysts
- Most patients are asymptomatic with cysts detected incidentally on chest imaging 2
- When symptomatic, patients may experience chest discomfort, dyspnoea, cough, or palpitations due to compression of the heart 2
- Typically appear as oval, homogeneous radio-dense lesions, usually at the right cardiophrenic angle on chest X-rays 2
Hydatid Cysts (Echinococcal)
- Often asymptomatic until they grow large or leak 2
- Right upper quadrant pain and fever if cysts leak or become infected 2
- Hepatomegaly, cholestasis, biliary cirrhosis, portal hypertension, or ascites with large liver cysts 2
- Anaphylaxis or secondary cyst formation if cysts rupture into the peritoneal space 2
- Eosinophilia may indicate cyst leakage 2
Breast Cysts
- Focal breast pain that may be relieved by drainage of the cyst 2
- Palpable mass that may be tender 2
- Simple cysts are typically benign with very low malignancy risk (<0.4%) 2
Ovarian/Adnexal Cysts
- Often asymptomatic, especially if small 2
- Pelvic pain or pressure when cysts are large 2
- Characteristic symptoms based on cyst type:
Bone Cysts
- Pain and/or swelling at the affected site 3, 4
- Symptoms typically present for less than 6 months 3
- Pathological fractures may occur 4
- In aneurysmal bone cysts, approximately 80% of patients are under 20 years old 3
Vaginal and Vulvar Cysts
- Often asymptomatic and benign 5, 6
- When symptomatic, may present as swelling or mass in the vagina 6
- May be accompanied by stress incontinence, dyspareunia, or dysfunctional uterine bleeding 6
- Most commonly located in the lateral and posterior walls of the vagina 6
Brain Cysts (Colloid Cysts)
- Signs of increased intracranial pressure and hydrocephalus 7
- Headaches that may be positional or exacerbated by position changes 7
- Nausea and vomiting 7
- Altered mental status in severe cases 7
Complications That Cause Additional Symptoms
- Infection: fever, increased pain, erythema, and elevated inflammatory markers 1
- Hemorrhage: sudden onset of severe pain, may cause anemia if significant bleeding occurs 1, 8
- Rupture: acute pain, potential for peritonitis with abdominal cysts, or anaphylaxis with hydatid cysts 2, 1
- Compression of adjacent structures: symptoms depend on the affected organ (e.g., jaundice with bile duct compression, dyspnea with lung compression) 1
Clinical Pearls
- Pain that worsens with specific activities or positions may help localize the cyst 1
- Cysts that rapidly increase in size, are fixed, or are associated with bleeding require prompt evaluation, especially in patients over 40 years 5
- The presence of eosinophilia with a cyst may indicate leakage of a hydatid cyst 2
- Fluid-fluid levels seen on imaging may indicate hemorrhage within a cyst 3