Are Liver Cysts Common?
Yes, liver cysts are quite common, occurring in 2.5–18% of the general population, with prevalence increasing with age and a female predominance. 1, 2, 3
Prevalence in the General Population
- Simple hepatic cysts occur in 2.5–18% of the population, making them a frequently encountered incidental finding on abdominal imaging. 1, 2
- The prevalence increases progressively with age, becoming more common in older adults. 3
- There is a clear female predominance (approximately 2-3:1 female-to-male ratio) across most studies. 3, 4
- These cysts show a preference for the right lobe of the liver and can occasionally be multiple. 3
Context: Polycystic Liver Disease vs. Simple Cysts
While simple hepatic cysts are common in the general population, it's important to distinguish them from polycystic liver disease (PLD):
- In patients with autosomal dominant polycystic kidney disease (ADPKD), liver cysts are present in >80% by age 30 years, representing the most frequent extrarenal manifestation. 5
- However, most people with ADPKD will not develop clinically symptomatic PLD despite having liver cysts. 1
- The prevalence of isolated polycystic liver disease (without kidney involvement) is much rarer at 1/10,000–1/158,000. 1
Clinical Significance
- The vast majority (>90%) of hepatic cysts are non-neoplastic and benign, requiring no treatment when asymptomatic. 4
- Mucinous cystic neoplasms (MCNs), which carry malignancy risk, are rare, with an estimated prevalence <5% compared to simple hepatic cysts. 1
- Malignant cystic lesions represent <2% of all hepatic cysts. 4
Detection and Diagnosis
- The increased detection of liver cysts is largely due to widespread use of enhanced radiological imaging techniques, particularly ultrasound, CT, and MRI. 1, 2
- Ultrasound is the most useful first-line, noninvasive tool for detecting and characterizing simple hepatic cysts. 6
- Most cysts are discovered incidentally during imaging performed for unrelated reasons. 2, 7