Epidermoid cyst of the spleen, a case report

Abstract

Introduction: Splenic tumors are rare and are either primary or secondary, benign or malignant. Most have none to minimal symptomatology and are found incidentally. Splenic cysts can be infectious, congenital, or traumatic. Epidermoid cysts and parasitic cysts are examples of primary cysts and usually have a classic presentation on imaging. Despite advanced imaging modalities and patient's clinical presentation, it can be difficult to diagnose an epidermoid cyst without histological examination. The purpose of this paper is to discuss typical findings of primary splenic cysts on imaging, but how they may differ in appearance.

Presentation of case: 51 year old female who presented with vague abdominal discomfort and was found to have a large splenic mass with cystic components on imaging which did not demonstrate a typical primary splenic cyst appearance. Patient underwent an uneventful hand-assisted laparoscopic total splenectomy and had an uneventful recovery with histopathology revealing an epidermoid splenic cyst.

Conclusion: Primary splenic cysts are difficult to diagnose and differentiate with imaging alone. They have a variable presentation and can present like as a cystic mass. It is important to include them in the differential diagnosis of splenic masses since histopathology is the final determinant of the diagnosis.

Keywords: Case report; Epidermoid cyst of spleen; Imaging of splenic epidermoid cyst; Splenic cyst; Splenic tumor.

Fig. 1

Ultrasound Appearance of Splenic Mass.

Fig. 2

Enhanced CT scan appearance of Splenic Mass.

Fig. 3

Gross Surgical Pathology of Splenectomy with Tumor.

Fig. 4

Pathological Specimen.