Hepatorenal Polycystosis Complicated By Hepatic Cirrhosis: A Case Report

Polycystic liver disease is most commonly associated with autosomal dominant polycystic kidney disease. Hepatic cysts are the most common extrarenal manifestation of autosomal dominant polycystic kidney disease. The progression to cirrhosis remains rare, and the data is sparse, the only curative treatment is liver transplantation. We report the case of a young patient with hepato-renal polycystosis at the stage of cirrhosis.

Simple Hepatic Cysts as Markers of Thoracic Aortic Disease

Objective: Thoracic Aortic Disease (TAD) is potentially lethal, yet difficult to detect as most patients are asymptomatic until the aneurysm dissects and becomes life threatening. Several clinical markers for TAD have been identified such as: bicuspid aortic valve, intracranial aortic aneurysm, bovine aortic arch, positive family history, and simple renal cysts. The aim of this study was to investigate the prevalence of Simple Hepatic Cysts (SHC) among individuals diagnosed with TAD in order to assess whether they can be used as a predictor of TAD. Methods: In this retrospective study, the prevalence of SHC for (n=1244) hospital patients treated for TAD was evaluated and compared to a control group of (n=809) patients. TAD patients were divided into four subgroups: ascending aneurysm (788; 63.3%; descending aneurysm (123; 9.9%); type A dissection (137; 11%); type B dissection (196; 15.8%). The presence of SHC was determined based on either computed tomography, magnetic resonance imaging, or ultrasound imaging of these patients. Results: Prevalence of SHC was 14.8%, 11.4%, 12.4%, and 14.8% in patients with ascending aneurysm, descending aneurysm, type A dissection, and type B dissection, respectively. Prevalence of SHC in the control group was 3.8% (p<0.001). The prevalence of SHC was not significantly different between males and females among the TAD patients as well as the control population. Conclusion: Individuals with TAD have an increased prevalence of SHC compared to individuals without TAD. SHC can potentially be used as a clinical marker to detect patients at risk for TAD.

LAPAROSCOPIC TREATMENT OF CONGENITAL NONPARASITIC LIVER CYSTS IN NEWBORNS

Congenital nonparasitic liver cysts in newborns are rare. Surgical excision of these formations is necessary to prevent complications. Reports of laparoscopic treatment of simple liver cysts in children are also rare. Authors present a series of endosurgical treatment of patients, numbering 3 children and coming from a single surgical center, and compare it with the literature data known to date. Data of 3 patients with nonparasitic liver cysts were collected at the Center for Neonatal Surgery, beginning in 2014. The analysis of the patient's demographic data and parameters of hepatic cysts (location, histological structure) is performed. Early and long-term results of laparoscopic operations were studied. All patients were newborns: 2 girls and 1 boy. The primary diagnosis was set during prenatal ultrasound examination. In all patients a complete resection of pathological liver formations was performed using laparoscopy. There were no complications during early postoperative period. In the long-term follow-up period, there were no disease recurrences. The study presents one of the largest series of laparoscopic excision of nonparasitic liver cysts in newborns. The study revealed that laparoscopy is a safe and effective method of treating of congenital hepatic cysts.

Giant haemorrhagic hepatic cyst with flame-like morphology in a patient with polycystic kidney and liver disease

Introduction Intracystic haemorrhage is a rare complication of hepatic cysts, and is often mistaken for a malignant lesion. Case Report A 55-year-old female with a history of polycystic kidney and liver disease presented with a six-month history of abdominal distension, abdominal pain, early satiety, shortness of breath and 5 kg of weight loss. Imaging revealed a 20 cm mixed solid-cystic hepatic lesion containing peripheral avascular mobile echogenic material with a flame-like morphology. After experiencing symptomatic relief from ultrasound-guided aspiration, the patient underwent cyst fenestration for more definitive treatment. Discussion Haemorrhagic hepatic cysts are uncommon and may present on imaging as having lace-like retractile clot, internal layering or shading of separating blood products or avascular mobile flame-like excrescences. The presence of avascular mobile flame-like excrescences appears to be a unique feature of haemorrhagic hepatic cysts. Conclusion While haemorrhagic hepatic cysts are rare and commonly mistaken for biliary cystadenomas or adenocarcinomas, the identification of particular features on high-resolution magnetic resonance imaging and contrast-enhanced ultrasound can lead to the correct diagnosis.