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Cysts

by Josephine Andrews
Published: Last Updated on 415 views

cyst (from the Greek “kystis” = bladder, urinary bladder) is a liquid-filled, encapsulated cavity in the tissue. It can consist of one or more chambers, be large or tiny. Most cysts are benign. Read here why cysts form, what symptoms they can cause and how they are treated!

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

N43 K76 N60 M71 N83 L72 N28 Q44 Q61 E28

Cysts: causes and forms

Cysts can develop in any part of the body and at any age. The reasons for this are diverse.

Some cysts develop from obstructed drainage from a cavity that produces or contains fluid. For example, if the duct of a sebum gland in the skin is blocked, a sebum cyst (a type of blackhead) can form.

In other cases, cysts develop as a result of chronic diseases (e.g. lung cysts in cystic fibrosis ), hereditary diseases (e.g. cystic kidneys or cystic liver), tumors or as part of developmental disorders in the embryo .

Infections with parasites (such as the dog or fox tapeworm: echinococcosis ) can also cause organ cysts. In addition, cysts can form under the influence of hormones , for example on the female breast , ovaries or testicles .

Examples of cysts that occur more frequently are:

One speaks of a “true cyst” when it is lined with cells. A pseudocyst, on the other hand, is surrounded by connective tissue.

Cysts: Symptoms and Investigations

symptoms

The symptoms that cysts cause depend, among other things, on the type of cyst, where it originated and its size. Some cysts present with swelling that you can see or feel, such as a cyst in the breast. A Baker’s cyst in the back of the knee can also be palpable from a certain size. It can also cause a vague feeling of pressure, pain and even numbness in the lower leg.

Other cysts go unnoticed for a long time because they are located on internal organs (such as kidneys , liver ).

Whether a cyst causes symptoms or not does not determine whether it is benign or malignant (most cysts are benign!).

investigations

Cysts on internal organs that do not cause any symptoms are often only discovered by accident – for example during an ultrasound examination that is carried out routinely or because of another illness.

Additional tests are sometimes necessary to determine the size and cause of the cyst more precisely. These include:

  • Computed tomography (CT)
  • Magnetic resonance imaging (magnetic resonance imaging, MRI)
  • X-rays
  • blood tests
  • Cyst puncture (where the doctor removes some liquid from the inside of the cyst with a fine hollow needle in order to have it examined more closely in the laboratory)

renal cysts

Renal cysts can occur singly or in multiples on one or both kidneys. As a rule, they do not cause any symptoms and are therefore usually only discovered by accident. However, large cysts can cause pain in the back or abdomen.

Cysts in the kidney can become inflamed or burst, or there may be bleeding into the cyst. Renal cysts rarely turn malignant. Occasionally they occur in combination with a tumor of the blood vessels (haemangioblastoma) of the cerebellum or the retina . This condition is inherited and is called Hippel-Lindau syndrome .

Kidney cysts are rare in people under the age of 30. They become more common with age. More than 20 percent of people over the age of 60 have one or more cysts on their kidneys.

A cyst on the kidney that isn’t causing any problems doesn’t necessarily need treatment. Large cysts that are associated with pain or complications can be punctured by the doctor with a needle to suck out the fluid they contain ( puncture ). He can have the fluid in the cyst examined under a microscope. Under certain circumstances, he can obliterate or remove the cyst in an operation.

cystic kidneys

Simple renal cysts should not be confused with cystic kidneys. Autosomal Polycystic Kidney Disease (ADPKD) is one of the most common hereditary diseases. It occurs in about one in 1000 people. Due to changes in the genetic material (PKD1 or PKD2 gene), those affected develop more and more cysts in the kidneys over the course of their lives – until the organs no longer function. Most patients between the ages of 50 and 60 suffer from kidney weakness ( renal insufficiency ).

But the disease does not only affect the kidneys. Cysts can also form in other organs ( e.g. pancreas , liver, lungs , spleen , ovaries, uterus , testicles or thyroid gland ). Some sufferers also develop bulges in the wall of the main artery ( aortic aneurysm ) or the wall of the intestine ( diverticulosis ).

Polycystic kidney disease can lead to various complications and there is currently no cure. Treatment is only required if symptoms such as urinary retention or urinary tract infections occur.

There is currently no drug that can be used to treat cystic kidneys causally. Therapy aims to relieve symptoms.

liver cysts

One or more cysts in the liver usually cause no symptoms. They are usually discovered by accident during an ultrasound scan. Large cysts over ten centimeters in diameter, on the other hand, can cause a feeling of pressure in the upper abdomen, nausea or jaundice .

Treatment is usually not necessary for liver cysts unless a cyst causes symptoms. Then the doctor can prick it through the skin with a fine needle, suck out its contents, and inject an alcohol solution designed to destroy the cyst. The affected person rarely has to have the cyst removed in an operation (cyst resection).

Liver cysts in hydatid disease

Not all liver cysts are harmless. Infection with dog or fox tapeworm can also cause cysts in the liver. Echinococcosis is a serious disease that is fatal if left untreated!

cyst liver

Cystic liver is a hereditary disease. It is caused by changes in the genetic material (mutations), more precisely in the genes PKD-1 and PKD-2. The liver of those affected is covered with cysts from birth . But she can still do her job for a long time.

The cysts in the liver can be easily detected using ultrasound. Depending on their size, they cause a feeling of pressure and pain in the upper abdomen. If the cysts get bigger, they can press on the stomach and intestines . Patients lose their appetite, may vomit more frequently, and lose weight.

The symptoms can be relieved in the short term if the doctor punctures the cysts and sucks out the liquid. After a while, however, liquid usually flows in – the cysts fill up again. It is also possible to surgically remove part of the liver (partial liver resection). In some cases, only a liver transplant helps .

There are no medications that can heal a cyst liver.

Ovarian cysts (ovarian cysts)

Cysts on the ovary can be congenital – they form as a result of maldevelopment during the embryonic period. This happens, for example, with the so-called dermoid cysts. They may contain other types of tissue, such as hair or teeth .

In most cases, however, ovarian cysts are acquired and develop as a result of the normal hormonal fluctuations during a woman’s menstrual cycle. Some ovarian cysts also form as a result of taking hormonal drugs.

Ovarian cysts often cause no symptoms. Occasionally, however, dull pain in the lower abdomen or menstrual disorders (e.g. missed or heavy periods) can also occur. Acute abdominal pain is possible, for example, when a cyst ruptures. An ovarian cyst that is pedunculated and twists on its own axis can even cause severe abdominal pain . In addition, if they are very large, ovarian cysts can press on the bladder or bowel. If the cysts are oestrogen-producing, spotting can occur.

Treatment depends on the symptoms and the size of the cyst or cysts. In many cases you can wait and see. Some women are helped by drugs that suppress ovulation (such as the pill ). If the cysts do not regress, the doctor can surgically remove them as part of a laparoscopy (laparoscopic cyst extirpation).

Polycystic ovary syndrome

Eight or more cysts in one ovary can indicate polycystic ovary syndrome ( PCO syndrome ). In this disease, the ovaries produce more male sex hormones. Women are gaining weight, getting acne , their voices are getting deeper, their body hair is growing.

endometriosis

Ovarian cysts can also occur in endometriosis . In this condition, the lining of the uterus grows outside the uterus, for example in the abdomen, ovaries or fallopian tubes. Endometriotic cysts are typically filled with waste products from the blood. Because of their brown color, they are also called chocolate cysts.

hydrocele of the testicle (hydrocele)

hydrocele describes a buildup of fluid in the testicles. It can be congenital or acquired over the course of life.

The scrotum is usually enlarged and bulging with a hydrocele. In the ultrasound , the doctor can recognize the hydrocele well and distinguish it from other changes in the testicles (e.g. a tumour).

In the case of a congenital hydrocele that does not cause any symptoms, you can wait until the boy is one year old – the hydrocele sometimes resolves spontaneously during this period. The doctor will operate on older children with a congenital hydrocele because they can otherwise get a hernia later on.

In the case of acquired hydroceles, the doctor first treats the underlying disease (e.g. inflammation of the testicles and epididymis ) and then removes the hydrocele in an operation.

Cyst in the back of the knee (Baker’s cyst)

A Baker’s cyst is a cyst that arises from the posterior joint capsule in the knee joint . It occurs in diseases of the knee in which a chronic joint effusion occurs (e.g. rheumatic diseases). The posterior joint capsule can then protrude and a cyst can form.

A resilient swelling can be felt in the hollow of the knee of those affected. It can also hurt when the knee is bent. In rheumatic diseases, the cyst can become so large that it continues into the lower leg. Such large cysts can squeeze blood vessels and cause circulatory problems. This manifests itself in numbness in the lower leg or foot and perhaps even signs of paralysis.

Small cysts, on the other hand, cause hardly any symptoms and can also remain untreated. A Baker’s cyst often regresses spontaneously if the doctor successfully treats the underlying disease. Large cysts that cause symptoms can be surgically removed.

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