Ex vivo resection of giant epidermoid cyst and vascularized partial splenic autotransplantation: 3.5-year follow-up

Abstract

SPLENIC CYSTS are rare findings that are classified as either parasitic or nonparasitic. Approximately half of these cysts are diagnosed incidentally. For larger, nonparasitic cysts (>5 cm in diameter), either complete or partial splenectomy is the treatment of choice. The preservation of partial healthy splenic parenchyma is a preferred option as a result of increasing awareness of the risk of overwhelming postsplenectomy infections (OPSIs), especially in children. Various spleenpreserving procedures, such as cyst aspiration, partial or complete cystectomy, or partial splenectomy, have been reported in the literature. In recent years, laparoscopic spleen-preserving surgery has been the preferred treatment of choice for large cysts, especially those located in the pole of the spleen. Spleen-preserving surgery, however, is still a challenging procedure for large cysts with hilar location or multifocal lesions. In this report, we describe a case of a large splenic epidermoid cyst involving the hilum that was managed successfully by ex vivo resection of the cyst and partial splenic autotransplantation. To our knowledge, this is the first known case of vascularized partial splenic autotransplantation with a 3.5-year follow-up.