Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep:86:106317.
doi: 10.1016/j.ijscr.2021.106317. Epub 2021 Aug 18.

Large expanding splenic pseudocyst: A case report and review of literature

Bakhos Alhaddad  1 , Abdul Azim Hussain  2 , Haitham Al-Rawi  3 , Rafif Mahmood Al Saady  4
Affiliations

Large expanding splenic pseudocyst: A case report and review of literature

Bakhos Alhaddad et al. Int J Surg Case Rep. 2021 Sep.

Abstract

Introduction and importance: Splenic pseudocysts are extremely uncommon. Most of these cysts are asymptomatic and may result from previous blunt abdominal trauma. We report an interesting uncommon case of large splenic pseudocyst without history of previous abdominal trauma.

Case presentation: A 56 year old male patient, presented with symptoms of pain in the left side of middle back and discomfort in the left hypochondrium for few months. His physical examination was unremarkable. The abdominal Ultrasound and contrast-enhanced Computed tomography showed a large splenic cyst occupying most of the splenic parenchyma. Echinococcus multilocularis antibody test was negative. The differential diagnosis of this case included non-parasitic splenic cysts. The patient underwent elective exploratory laparoscopy which was converted to laparotomy with total splenectomy. Histopathological examination of the specimen revealed a splenic pseudocyst.

Clinical discussion: The splenic cyst in this case was symptomatic due to its large size. It was hard to elicit an etiology as there was no history of abdominal trauma, infection, or degenerative disease. The main factors in selecting either conservative or radical surgical approach for such cases are the cyst location, cyst size, and the residual splenic parenchyma.

Conclusion: The goal of splenic pseudocysts treatment is to relieve symptoms and avoid complications. Partial splenectomy is the recommended procedure when the size and location of the cyst allow preservation of at least 25% of splenic parenchyma. Otherwise, Total splenectomy is unavoidable.

Keywords: Case report; Non-parasitic splenic cyst; Splenectomy; Splenic pseudocyst.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential conflict of interest related to this manuscript.

Figures

Fig. 1
Fig. 1
CT scan of the abdomen, Axial view showing a large splenic cyst with calcified wall, occupying most of the splenic tissue.
Fig. 2
Fig. 2
Intraoperative images of the cyst lesion occupying most of the splenic tissue.
Fig. 3
Fig. 3
Microscopic appearance of cyst wall (Hematoxylin and Eosin ×100).
Fig. 4
Fig. 4
Microscopic appearance of the spleen (Hematoxylin and Eosin ×100).
See this image and copyright information in PMC

References

    1. Robbins F.G., Yellin A.E., Lingua R.W., Craig J.R., Turrill F.L., Mikkelsen W.P. Splenic epidermoid cysts. Ann. Surg. 1978;187:231–235. - PMC - PubMed
    1. Gibeily G.J., Eisenberg B.L. Splenic pseudocysts—diagnosis and management. West. J. Med. 1988;148:464–466. - PMC - PubMed
    1. Verma A., Yadav A., Sharma S. A rare splenic pseudocyst. J. Surg. Case Rep. 2013;9 doi: 10.1093/jscr/rjt086. - DOI - PMC - PubMed
    1. Roberson F. Solitary cysts of the spleen. Ann. Surg. 1940;111:848–850. - PMC - PubMed
    1. Altintoprak F., Dikicier E., Kivilcim T., Ergonenc T., Dilek O.N. An uncommon clinical entity, although common theoretically: pseudocyst of spleen—two case reports and review of the literature. Eur. J. Gen. Med. 2012;9