Imaging of hepatic cystic tumors

Cystic tumors of the liver are a heterogeneous group of neoplasms with characteristic histogenesis, clinico-biological features, and pathologic findings. They include both epithelial and mesenchymal liver tumors and commonly originate from the biliary epithelium. Mucinous cystic neoplasm (MCN) and intraductal papillary neoplasm of the bile duct (IPNB) are the most common cystic neoplasms of the liver. Cystic changes can develop in hepatocellular carcinoma (HCC) and hepatic metastases due to cystic degeneration and necrosis. Rarely, mass-forming intrahepatic cholangiocarcinoma and giant cavernous hemangioma may also show cystic appearance with necrotic areas. Rare hepatic tumors such as mesenchymal hamartoma, undifferentiated embryonal carcinoma, lymphangioma, and inflammatory myofibroblastic tumors are also cystic in nature. Select cystic hepatic tumors show characteristic cross-sectional imaging findings that permit an accurate diagnosis. Imaging is also pivotal in the follow-up and long-term surveillance of cystic hepatic tumors.