Cysts of the Liver

This research aims to describe the clinical, histological, and radiological features of rare primary liver cancers. It focuses on collecting tumor and blood samples to better understand these cancers and to evaluate how well treatments used in real-world practice work, with the goal of identifying the best treatment sequences. The study serves as a foundation for future research to find new molecular and imaging biomarkers that could improve diagnosis and prognosis. The study is observational and retrospective, meaning it reviews past cases from multiple centers in France. It collects biological samples and clinical data from patients diagnosed with rare primary liver cancers after January 2018. The study evaluates treatments patients have received in clinical practice without assigning any new treatments or interventions. Participants data, including clinical characteristics, tumor biology, and imaging, will be reviewed for up to five years from diagnosis. Researchers will measure outcomes such as recurrence-free survival for patients without metastases, progression-free survival for those with metastases, and overall survival. The study includes both living patients who consent to participate and deceased patients, aiming to gather comprehensive information to support future translational studies.

Researchers are studying the effect of the hormone-related drug leuprorelin on liver growth in pre-menopausal women with very severe polycystic liver disease. The trial focuses on women whose liver volume continues to grow despite current treatments and who are at risk of needing a liver transplant. This phase 2, randomized, single-blind study is sponsored by the University Medical Center Groningen and aims to assess liver growth over 36 months. Participants are assigned to one of two groups the direct start group receives leuprorelin injections for 36 months, beginning with monthly doses for the first three months followed by injections every three months the delayed start group receives standard care for 18 months before starting leuprorelin for the next 18 months. The study monitors multiple health aspects including liver and kidney growth, hormone levels, bone density, and vital signs throughout the treatment period. Women involved in the trial will undergo regular MRI or CT scans, blood tests, and assessments of physical and mental health over three years. Researchers will track liver size changes as the primary outcome, along with symptoms related to liver disease, menopause, depression, and overall health. Safety is monitored by recording any serious adverse events, and participants provide informed consent before joining the study.

Researchers are studying the effects of foam sclerotherapy on large kidney or liver cysts in patients with autosomal dominant polycystic kidney disease ADPKD and autosomal dominant polycystic liver disease ADPLD. These cysts can cause discomfort and reduce quality of life, and this observational study aims to understand how foam sclerotherapy influences cyst size and patient-reported quality of life over a 12-month period. The study leverages a patient-reported outcome tool approved by the FDA to measure symptom burden in polycystic liver disease. The study observes patients who undergo foam sclerotherapy using 3% Sodium Tetradecyl Sulfate Sotradecol, a treatment currently approved for varicose veins. Patients have 1 to 3 large, non-exophytic cysts causing compressive symptoms, and researchers monitor changes in cyst volume and symptoms. The procedure targets cysts in the liver or kidney, and follow-up visits occur up to 12 months after treatment to assess changes. Participants will be assessed at baseline and then at 1 month, 6 months, and 12 months after treatment. Researchers collect data on pain, quality of life, and health-related quality of life using specialized questionnaires validated for this condition. Organ volumes are measured through imaging to track cyst changes. Patients must comply with follow-up visits, provide informed consent, and the study excludes those who are pregnant or have too many or too small cysts. Overall participation can last over a year to measure the treatments impact.

Researchers are studying hepato-renal fibrocystic diseases HRFD, which include rare conditions like Autosomal Recessive Polycystic Kidney Disease ARPKD, Joubert syndrome, Bardet Biedl syndrome, Meckel-Gruber syndrome, congenital hepatic fibrosis, Caroli syndrome, oro-facial-digital syndrome, nephronophthisis, and glomerulocystic kidney disease. The study aims to create a coordinated clinical and genetic database to improve diagnosis, treatment, and research progress by sharing information and biological samples among institutions. Participants can contribute to a clinical database by allowing access to their medical records, which will be anonymized and entered into a shared database. Optional parts of the study include genetic testing through blood or saliva samples from the participant and their parents, as well as donating tissue samples collected during medical procedures or autopsies. These samples will be stored in specialized repositories to support future research. Participants will have their medical records reviewed periodically, with initial data entry and annual follow-ups for the duration of the study or until they choose to withdraw. Genetic and tissue samples will be processed and stored securely. The main outcome is the development and maintenance of a comprehensive translational resource for HRFD over five years. The study does not require clinic visits and involves minimal participant burden while contributing valuable data and materials for ongoing research.

Researchers are evaluating ways to improve surgical treatment outcomes for liver echinococcosis complicated by biliary fistulas. The study aims to optimize diagnostic methods for early detection of biliary fistulas and improve surgical techniques to better eliminate these complications. This research focuses on refining both the diagnosis and treatment approaches to enhance patient recovery and reduce postoperative issues. The study involves conservative surgical treatment for liver echinococcosis where occult biliary fistulas are identified and managed by applying a U-shaped suture followed by medical cyanoacrylate glue between suture stitches on the fibrous capsule near the fistula. This method is being assessed to determine its effectiveness in managing biliary fistulas during surgery. Participants will be monitored for up to three months after surgery. Researchers will measure the incidence of bile leakage, the time it takes for biliary fistulas to close, treatment costs, and patients quality of life after surgery. Detailed postoperative data including patient condition, discharge characteristics, complications, and hospital stay duration will be collected to evaluate outcomes and recovery progress.

Echinococcosis is a parasitic disease caused by Echinococcus species, affecting humans through zoonotic transmission. Diagnosis currently relies on imaging, serology, and microscopy, but microscopy is slow, less sensitive, and cannot reliably identify different Echinococcus species. This research aims to improve the molecular diagnosis and understanding of pulmonary echinococcosis by developing new diagnostic methods. The study involves collecting biological samples from patients suspected of having echinococcosis, especially those requiring surgery to remove cysts. Researchers will develop and optimize a homemade PCR protocol to detect parasitic genetic material and differentiate among four Echinococcus species. The molecular results will be compared with traditional serology and microscopy, and whole-genome sequencing will be used to characterize species. Participants will provide biological samples which, alongside clinical and microbiological data, will be analyzed to enhance diagnostic accuracy. The study will monitor outcomes such as the development of the PCR protocol and hospitalization costs over an expected 20-year period. This observational study includes patients aged 6 years and older and involves informed consent and follow-up assessments related to diagnostic advancements.

Liver abscess is a serious medical condition that requires prompt treatment using antimicrobials, with or without drainage of the abscess. This trial investigates the comparison between intravenous Beta-lactam antimicrobials plus Metronidazole and oral Cefixime plus Metronidazole for treating uncomplicated liver abscesses. The study aims to clarify the best antimicrobial approach, as current practices lack clear clinical trial evidence, especially regarding the use of intravenous antibiotics upfront. Participants diagnosed with liver abscess through imaging will be randomly assigned to one of two treatment groups. One group receives intravenous Beta-lactam antimicrobials such as Piperacillin-Tazobactum, Ceftriaxone, Meropenem, or Imipenem-Cilastatin plus intravenous Metronidazole for two weeks. The other group receives oral Cefixime plus oral Metronidazole for two weeks. Both groups will receive standard care, including drainage or aspiration when indicated, and will be followed for eight weeks. During the study, participants will be monitored for clinical cure, treatment failure, mortality, therapy duration, recurrence, adverse reactions, complications, hospital stay length, and readmissions over an eight-week period. Researchers will assess these outcomes to compare the effectiveness and safety of the two treatment strategies. The study includes regular evaluations and aims to provide evidence to guide antimicrobial use in liver abscess management.

Echinococcosis is a serious parasitic disease caused by tapeworm larvae, leading to alveolar or cystic echinococcosis. Treatment often involves surgery or benzimidazole drugs like albendazole, which slows parasite growth but doesnt kill it, requiring lifelong use and regular monitoring. Diagnosis uses imaging and blood tests, but sensitivity varies, especially in patients with weakened immune systems. Researchers are evaluating a new multiplex quantitative PCR QPCR-Echino test to detect DNA from the parasites in blood and tissues, aiming to improve diagnosis and monitoring, particularly in immunocompromised patients who face delays in diagnosis. The study involves collecting blood samples to perform the new QPCR-Echino test at the start and after one year. This test targets DNA from Echinococcus multilocularis and Echinococcus granulosus species found in Europe. The goal is to assess how well this new technique performs compared to current methods for diagnosing echinococcosis. Participants will provide blood samples upon joining the trial and again after one year. Researchers will analyze these samples using the QPCR-Echino method to evaluate diagnostic accuracy and effectiveness over time. The study will measure performance indicators of this diagnostic technique within one year, helping to improve detection and management of echinococcosis. The total participation time includes initial and one-year follow-up blood testing.

This research aims to evaluate, treat, and monitor patients with known or suspected parasitic infections. It includes people aged 3 years and older and focuses on understanding different parasitic infections such as malaria, intestinal worms, GI protozoa, echinococcus, and strongyloides. The study is observational and does not involve experimental treatments but follows standard medical care practices. Participants are evaluated through medical history reviews, physical exams, and routine laboratory tests including blood, stool, or urine tests. Additional tests may include x-rays, EKGs, or tissue biopsies depending on the individuals condition. Treatment plans are personalized and follow standard care, with the number and length of visits adapting to each participants needs. Throughout the study, participants will attend scheduled clinic visits for evaluation and monitoring. Blood samples may be taken regularly, within safe limits, and other diagnostic procedures will be conducted as needed. The study team measures responses to treatment and monitors health status over time, with visit frequency and study duration tailored by the doctor based on the participants condition.

This research focuses on cystic lesions in the anterior mediastinum, such as thymic cysts, bronchogenic cysts, pericardial cysts, cystic thymoma, and cystic teratoma. The study aims to improve the accuracy of diagnosing these cystic lesions by reviewing cases from 2000 to 2022. It is an observational, multicenter trial led by Maastricht University Medical Center to better understand these conditions and their treatment options. The study does not involve any specific intervention or treatment but collects and analyzes patient data, characteristics, complications, and comorbidities related to anterior mediastinal cysts. The research includes patients who have undergone radiological imaging and have approval for follow-up. Data from these patients will be reviewed to assess diagnostic accuracy and clinical outcomes. Participants will be involved through data collection based on their existing medical records and follow-up approvals. Researchers will evaluate diagnostic success rates and associated patient information over the study period. No additional procedures or treatments are administered as part of the study. The study began in December 2022 and will continue until December 2027, aiming to gather extensive clinical data on these cystic lesions.