A CASE OF EPIDERMOID CYST OF THE SPLEEN PRESENTED WITH A SOLITARY SPLENIC ABSCESS

Abstract

Epidermoid cysts of the spleen are relatively rare, and most of them are found incidentally as an asymp-tomatic mass in the left upper quadrant. In this paper, an extremely rare case of epidermoid cyst of the spleen presented with a solitary splenic abscess is reported. A 26-year-old woman without previous medical history was admitted to the hospital because of high fever and left hypochondric pain. A infant'head-sized, elastic soft tumor was palpated in the upper quadrant. White blood cell count was 10, 700/mm and CRP was 15.0mg/dl. Computed tomography and ultranonography demonstrated a huge cystic mass in the left subphrenic space. The serum CA 19-9 levels were as high an 97U/ml and 122U/ml, respectively. Echo-guided needle aspiration of the cyst yielded a fluid that was positive for Staphylococcus aureus and the levels of CEA, CA 19-9, 194 CA 125 were extremely high, 76ng/ml, 20, 705U/ml, and 29, 400U/ml, respectively. Partial splenectomy was per-formed. Histologically, the inside of the cyst wall was mostly comprised of infiltrating cells and was partly cov-ered with a single layer of squamous cells. It was diagnosed as an epidermoid cyst of the spleen accompanied with splenic abscess. The postoperative course was uneventful.