Epidermoid cyst of the spleen

BMJ Case Rep. 2013 May 9:2013:bcr2013009707. doi: 10.1136/bcr-2013-009707.

Abstract

We report the case of a patient with a palpable mass and abdominal pain in the left upper quadrant. A physical examination revealed tenderness in this region. An ultrasound performed initially showed a large cystic structure. A CT examination revealed a large cyst originating in the spleen with loculations in its upper part and focal calcification in the wall. On MRI, the cystic mass showed high signal on T1-weighted and T2-weighted images. The carbohydrate antigen 19-9 (CA 19-9) was measured at 88 U/ml (standard <37.1 mUI/l). According to the imaging examinations and laboratory tests performed, it was impossible to determine if the splenic cyst was parasitic or non-parasitic. Given the most important risks of complications encountered in parasitic cysts, it was decided to treat this splenic cyst as a parasitic cyst. For this reason, an elective laparoscopic splenectomy with preoperative embolisation of the splenic artery was performed. The histological diagnosis was a primary epidermoid splenic cyst with inner lining epithelial cells.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / etiology
  • Adolescent
  • Animals
  • CA-19-9 Antigen
  • Calcinosis
  • Epidermal Cyst / diagnosis*
  • Epidermal Cyst / metabolism
  • Epidermal Cyst / surgery
  • Epithelial Cells
  • Female
  • Humans
  • Parasites
  • Spleen / metabolism
  • Spleen / pathology*
  • Spleen / surgery
  • Splenectomy*
  • Splenic Artery
  • Splenic Diseases / diagnosis*
  • Splenic Diseases / metabolism
  • Splenic Diseases / surgery

Substances

  • CA-19-9 Antigen