Nearly all patients with autosomal dominant polycystic kidney disease (ADPKD) develop
cysts in the liver as they age. 1 In addition, polycystic liver disease (PLD) also exists as a
genetically distinct disease in the absence of renal cysts. 2-4 In both cases, liver cysts arise
by excessive proliferation and dilatation of biliary ductules and peribiliary glands. Estrogen
receptors are expressed in the epithelium lining the hepatic cysts and estrogens stimulate
hepatic cyst-derived cell proliferation. 5 This explains why hepatic cysts are more prevalent …