Complex cystic liver lesions: classification, diagnosis, and management

Cystic liver disease has been increasingly reported in the literature, with a prevalence as high as 15-18%.Hepatic cysts are usually discovered incidentally, while their characterization and classification rely on improved imaging modalities.Complex cystic liver lesions comprise a wide variety of novel, re-introduced, and re-classified clinical entities.This spectrum of disorders ranges from non-neoplastic conditions to benign and malignant tumors.Their clinicopathological features, prognostic factors, and oncogenic pathways are incompletely understood.Despite representing a heterogeneous group of disorders, they can have similar clinical and imaging characteristics.As a result, the diagnosis and management of complex liver cysts can become quite challenging.Furthermore, inappropriate diagnosis and management can lead to high morbidity and mortality.In this review, we aim to offer up-to-date insight into the diagnosis, classification, and management of the most common complex cystic liver lesions.