OpenHealth Q&A

Concerns About Splenic Cyst and Severe Fatty Liver Disease

Subject: 33-Year-Old Female, 250 lbs, Caucasian Background. I am also diagnosed with PCOS, Hashimoto’s thyroiditis, and hypothyroidism. Starting January 2024, I began experiencing intermittent discomfort on my left side. Although it wasn’t excruciating, it certainly captured my attention. The sensation would occur randomly, lasting a few minutes before vanishing for days at a time. Given my existing issues with a small hiatal hernia and GERD, I initially attributed the discomfort to digestive problems. As time progressed, the episodes became increasingly frequent and would linger for several hours or even half the day. The discomfort never escalated to severe pain, but it was an annoying nagging feeling accompanied by a sense of fullness. I also noticed a rumbling and gassy sensation beneath my ribs on the left side. In May, I consulted my primary care physician, who arranged for a CT scan without contrast. To my relief, the results were clear, particularly because I had been informed that my spleen was enlarged during ultrasounds in both 2018 and 2022. I was elated to hear the scan reported as "unremarkable." However, the discomfort persisted. My doctor suggested I undergo a colonoscopy along with a HIDA scan to rule out colorectal and gallbladder complications, especially considering my family history of colon cancer. The HIDA scan indicated "mild" gallbladder issues, with a suggestion that surgery "could" be useful. Deep down, I felt certain that my gallbladder was not the issue, so I chose not to pursue surgical options. All my discomfort was consistently located on the left side. Fast forward to December 2024, and the discomfort began radiating to my left shoulder blade and left side of my back, similar to pain associated with kidney issues. After enduring over a year of uncertainty, by February 2025, I decided to take a significant step. I spent $2,500 and traveled eight hours for a full-body MRI through Prenuvo. The MRI results were alarming—a cyst measuring 17.60 mm was identified on my spleen, alongside a diagnosis of severe fatty liver disease, revealing that 36% of my liver is enriched with fat. This was distressing, prompting immediate lifestyle changes, leading to a loss of 10 pounds since the appointment, with aspirations to shed at least 70 more. A liver panel indicated normal results apart from elevated ALT levels (36, with a reference range of 6-29 u/l). My primary concern now centers around the splenic cyst. It’s shocking and frightening, especially since previous scans had not indicated its presence, including one from May 2024. I’m worried that it could have developed rapidly or perhaps was previously overlooked. Information on splenic cysts is scarce as they are quite rare, leaving me to wonder about the severity of this situation. Is there a possibility that this could indicate cancer? Thank you for your time. ❤️

Answers (1)

3/17/2025, 6:50:43 PM

OpenHealth AI

It's understandable to feel anxious about the discovery of a splenic cyst and the diagnosis of severe fatty liver disease, especially given your history of medical conditions. I want to reassure you that while these findings can be concerning, most splenic cysts are benign and do not indicate cancer.

Explanation:

1. Splenic Cysts: These are fluid-filled sacs that can occur in the spleen and are often detected incidentally during imaging studies. Most of the time, they are benign and do not require treatment unless they cause symptoms or complications.

2. Fatty Liver Disease: This condition can be related to obesity, diabetes, and other metabolic issues. While it can range from simple steatosis (fat accumulation without inflammation) to more severe forms that can cause liver inflammation, your priority should be on lifestyle changes to reduce fat in the liver rather than immediate worry about cancer.

Next Steps:

1. Monitor Symptoms: Keep a detailed record of your symptoms, particularly any changes in discomfort or new symptoms. This will be useful in follow-up discussions with your healthcare provider.

2. Follow-Up Imaging: Discuss with your doctor the need for follow-up imaging (like an ultrasound or repeat MRI) to monitor the cyst and ensure it remains stable. This may provide reassurance about its nature.

3. Address Fatty Liver: Continue your lifestyle changes aimed at weight loss—aim for a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Regular physical activity is also crucial.

4. Routine Blood Tests: Regular blood tests to monitor liver enzymes (ALT and others) will help track the health of your liver.

5. Consult a Specialist: If your primary care physician hasn’t referred you yet, consider seeing a gastroenterologist or a hepatologist, who specializes in liver conditions. They can provide more specific advice and share the latest management strategies for both the cyst and your fatty liver disease.

It's commendable that you've already started making positive lifestyle changes, and staying proactive will be key in managing your health concerns. If any new symptoms arise or if you have persistent worries, don't hesitate to reach out to your healthcare provider. Remember, you're not alone in this—support is available.