Splenic cysts diagnostic and treatment challenges

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Splenic cysts diagnostic and treatment challenges

Journal Title: Stanley Medical Journal - Year 2017, Vol 4, Issue 1

Abstract

Aim: Splenic cysts are a rare entity. Diagnosis can usually be established with the clinical context and imagery .They are generally considered as either true epithelial cysts or false pseudo cysts. The management mainly performed to prevent infection, haemorrhage, or rupture of the cyst. Discussion: 22-year-old female presented to the medical gastroenterology department with 4 months history of left hypochondrial pain. She denied any history of abdominal injuries, dyspepsia and constipation in the past. Base line laboratory investigations including haemoglobin, complete blood count were normal. Serological tests for HBsAg and HIV were nonreactive. Indirect haemagglutination test and enzyme-linked immunosorbent assay for detection of anti-Echinococcus antibodies were negative .On contrast CT scan of whole abdomen a large exophytically bulging well defined cystic lesion is seen measuring 12x10x10cm and replacing upper and mid part of spleen, extending superiorly up to left dome of diaphragm, medially indenting posterior and lateral wall of stomach and indenting the tail of pancreas. she underwent laparoscopic deroofing .Cyst measuring 15x10x10 cm was received in laboratory for histopathological examination. Microscopic examination revealed a true cyst with thin fibrous wall and a lining of cuboidal epithelium, chronic inflammatory cells infiltration and haemorrhage. There is no evidence of atypia or malignancy, the features are consistent with Primary epithelial cyst of the spleen. The postoperative course was uneventful and the she was discharged after 4 days of operation.Conclusion: Splenic epithelial cyst is an uncommon entity, it should be considered in the differential diagnosis of an abdominal mass in a young individual. Histopathology helps in the diagnosis and can help rule out the infectious and malignant differentials. Resection should be as limited as possible in order to avoid the risks of total splenectomy Partial laparoscopic decapsulation is an advantageous approach to large splenic cysts in children, because it is effective, preserves splenic tissue, and provides good medium-term result

Authors and Affiliations

Murali Ramamoorthy, Tony Fredrick, Venkateswaran A. R, Jeswanth S, Yuvaraj Jayaraman, Joseph K David

Keywords

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EP ID EP215731
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