Can these “cysts” in the physical examination report become cancerous?

Can these “cysts” in the physical examination report become cancerous?


Nowadays, the importance of regular physical examinations is gradually becoming known to everyone. Ultrasound examination has attracted attention as one of the important items of physical examination. Some unfamiliar medical terms such as “liver cyst” and “kidney cyst” on the report sheet are disturbing. In fact, there is no need to be nervous and worried. Liver cysts or kidney cysts found during physical examination are usually not a big problem, and most of them are harmless.

What should you do if you find a “kidney cyst”?

Q&A expert: Zhang Hailiang, deputy director and chief physician of the Department of Urology, Fudan University Cancer Hospital

Renal cysts, commonly known as “blisters”, have a very high incidence rate. Among people over 50 years old, more than 50% will have large or small renal cysts. The cyst wall of a simple renal cyst is very thin and consists of a single layer of squamous epithelium, and the cyst contains clear serous fluid. Simple renal cysts are generally benign lesions that naturally evolve slowly and usually only grow 1 cm in size within several years.

However, renal cysts may also turn into cancer, with a malignant transformation rate of 3% to 7%. The characteristic manifestations of malignant transformation of renal cysts mainly include: thickening of the cyst wall, calcification, separation, bleeding and new organisms in the cyst. If you do not pay attention to it or take it lightly, it is very easy to miss or misdiagnose it.

Doctors grade renal cysts through their B-ultrasound, CT and MRI manifestations. For grade Ⅰ~Ⅱ cysts, most of them are benign lesions and can only be observed and followed up. However, grade Ⅲ~Ⅳ cysts have a high probability of being malignant renal tumors and should be surgically explored and removed as soon as possible.

The vast majority of renal cysts are asymptomatic and usually do not have a significant impact on human health, so follow-up observation can be chosen. If the cyst is small and the patient does not feel any discomfort, no treatment may be performed temporarily; however, regular review is required to observe whether the cyst continues to grow and at what rate.

If there are symptoms or the cyst is large (diameter greater than 4 cm), after malignant tumors have been clearly ruled out, laparoscopic renal cyst deroofing and decompression is the first choice – removing the “roof” of the cyst to prevent accumulation of cyst fluid. Its advantages are less trauma and low recurrence rate. When the possibility of malignant transformation of a cyst is suspected, surgical exploration should be carried out promptly, and if necessary, the renal lesions should be completely removed.

What should you do if you find a “liver cyst”?

Q&A Expert: Wang Lu, Director and Professor of Liver Surgery, Fudan University Cancer Hospital

Liver cyst is a common benign liver disease, commonly known as “liver blister”. It is mostly round or oval in shape and consists of cyst wall and cyst fluid. The outer layer of the cyst wall is collagen-like tissue, and the cyst fluid is mostly clear or transparent. Light yellow liquid. Liver cysts are more common as single cysts, but they can also be multiple. They are often combined with renal cysts, and may also be combined with cysts of the pancreas, spleen, ovary, etc.

Liver cysts are caused by abnormal development of bile ducts during the embryonic period. Some bile ducts degenerate and lose connection with the channels. The epithelial cells in the abnormal bile ducts gradually grow and secrete fluid, forming “water sac”-like lesions. In most cases, the development of liver cysts remains static, the growth is not obvious, and most will not become cancerous. However, there are two rare situations that require vigilance in clinical practice: cystic liver cancer, which is often misdiagnosed as liver cyst; those with a long history of liver cysts, nodularity of the cyst wall was observed during follow-up, and some high liver cancer indicators.

Not all liver cysts need to be treated. There are several situations where liver cysts require active treatment: liver cysts are large (larger than 5 cm) or have symptoms of compression (compression of the stomach wall causing postprandial fullness, or compression of the bile duct causing jaundice, etc.); Rapid growth in a short period of time; secondary infection; secondary bleeding. The specific surgical method needs to be determined by the liver surgeon based on the patient’s images and a comprehensive assessment of the size of the cyst and the anatomical structures and connections between the cyst and the liver’s surrounding blood vessels and bile ducts.

Generally speaking, patients with liver cysts less than 5 cm in diameter and without clinical symptoms do not need treatment, but liver cysts cannot be completely ignored. Regular reexamination is required to observe changes in the size of liver cysts.

For new liver cysts, try to review the liver B-ultrasound every three months to half a year within 2 years to evaluate the growth rate of the liver cyst; for patients whose size does not change much in the short term, the follow-up time can be appropriately extended to every six months or one year. Have a B-ultrasound. At the same time, it is recommended that patients keep the results of each examination in order to compare changes before and after. It would be better if the same B-ultrasound doctor can do the examination.

【Related Links】

Ten tips for healthy living on “2.4 World Cancer Day”

1. Food diversity: Eat a variety of vegetables, fruits and roughly processed staple foods, mainly plant-based foods. Ensure 3 to 5 kinds of vegetables and 2 to 4 kinds of fruits every day. Pay special attention to the intake of dark vegetables rich in provitamin A, such as carrots, spinach, and fruits rich in vitamin C.

2. Maintain an appropriate weight and avoid being underweight or overweight.

3. Maintain appropriate physical activity and actively participate in sports that suit you.

4. Strictly quit smoking and it is recommended not to drink alcohol.

5. The daily intake of red meat (referring to beef, sheep, pork and their products) should be less than 80 grams. Choose poultry and fish as much as possible; consume an appropriate amount of soy products (tofu, etc.). Limit animal fat intake and choose vegetable oils in a limited amount. The total fat and oil energy supply accounts for 15% to 30% of the total energy.

6. The diet should be light but not salty. Do not use more than 6 grams of salt per day. Excessive salt will damage kidney function; limit sugar intake.

7. Do not eat moldy and spoiled food. When cooking fish and meat, the temperature should not be too high. Do not eat burnt food, grilled meat, or pickled food.

8. For food additives, pesticides and their residues, and other chemical pollutants, the safety limits must be monitored.

9. Follow your doctor’s instructions when taking medications and avoid drug abuse, such as non-steroidal anti-inflammatory drugs, certain antibiotics, etc.

10. Actively monitor and control blood pressure and blood sugar within normal ranges.



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