Giant hepatic cyst causing cardiac and critical inferior vena cava compression: an unusual presentation

Liver cysts are often detected as an incidental finding and require treatment in symptomatic cases due mainly to their exerted pressure effect. We present a case of a 77-year-old female patient who was diagnosed three years before with a giant hepatic cyst occupying the right hemi-liver and was subsequently referred to our hepatobiliary services following presenting with progressive dyspnoea, exertional fatigue in addition to bilateral lower limb oedema. Computed tomography imaging revealed an increase in cyst size with cardiac and significant inferior vena cava compression in addition to displacement of the right kidney. This case report highlights the importance of continued surveillance versus consideration of prophylactic drainage in carefully selected patients given the risks of future development of life-threatening complications.