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Case Reports
. 2022 Feb 8;14(2):e22012.
doi: 10.7759/cureus.22012. eCollection 2022 Feb.

Splenic Cysts and the Case of Mistaken Identity

Rachel M Krzeczowski  1 , Theresa N Jackson  2 , Wareef Kabbani  3 , Heather M Grossman Verner  1 , Phillip Sladek  4
Affiliations
Case Reports

Splenic Cysts and the Case of Mistaken Identity

Rachel M Krzeczowski et al. Cureus. .

Abstract

Endometriosis is a well-described pathology, with anatomic location of endometrial cell implantation extending both intraperitoneal and rarely extraperitoneal. Interestingly, previous reports indicated that the spleen enjoys immunity to endometriosis. Here, we present a patient with unremitting abdominal pain who, upon further workup, revealed multicystic disease of the spleen. The patient underwent an open splenectomy with pathology revealing intraparenchymal endometriosis likely due to seeding from traumatic splenorrhaphy. Two-week follow-up demonstrated resolution of symptoms and a well-healing incision with no postoperative complications.

Keywords: endometriosis; general gynecology; splenectomy; splenic cysts; trauma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Computer tomography demonstrating a multicystic splenic cyst
The spleen contains an 8-cm multiloculated cystic mass (star) with some mural calcifications (arrow) in the cysts.
Figure 2
Figure 2. H&E stain of the splenic tissue revealed histology consistent with endometrial cells
A: Low-power image showing splenic parenchyma with areas of fibrosis, evidence of past hemorrhage (cholesterol clefts (arrow)) and adjacent cystically dilated glandular structures (star) (H&E, ×20). B: Low-power image showing cystically dilated glandular structures within the spleen. Notice the condensed stroma with hemorrhage surrounding the glands (H&E, ×40). C: Endometrial-type glands with focal ciliated epithelium (arrow) (H&E, ×400). D: Note the endometrial stroma comprised of spindle cells with scant cytoplasm and ill-defined cell borders (star) surrounding endometrial-type glands (arrow) (H&E, ×400).
Figure 3
Figure 3. Immunohistochemistry demonstrates normal endometrial tissue with positive staining for Pax-8, WT-1, estrogen receptor, and CD10
Immunohistochemistry defined the endometrial cells with positive Pax-8 (A), WT-1 (B), estrogen receptor staining for epithelial cells of the endometrium (C), and CD10 staining for normal endometrial stroma (D). This is consistent with endometrial tissue.
See this image and copyright information in PMC

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References

    1. Surgical management of nonparasitic splenic cysts. Karfis EA, Roustanis E, Tsimoyiannis EC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015942/ JSLS. 2009;13:207–212. - PMC - PubMed
    1. Surgery of cysts of the spleen. Fowler RH. Ann Surg. 1921;74:20–36. - PMC - PubMed
    1. Computed tomography of the spleen: how to interpret the hypodense lesion. Karlo CA, Stolzmann P, Do RK, Alkadhi H. Insights Imaging. 2013;4:65–76. - PMC - PubMed
    1. McIntyre T, Zenilman ME. Current surgical therapy, 11th edition. Philadelphia, PA: Saunders; 2013. Cysts, tumors, and abscesses of the spleen; pp. 520–524.
    1. Clinical management of endometriosis. Falcone T, Lebovic DI. Obstet Gynecol. 2011;118:691–705. - PubMed

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