Splenic Epidermoid Cyst - A Rare Case Managed in a private medical college hospital of Bangladesh

Md Jahangir Hossain Bhuiyan,Md Mahbub Hasan,Md Mohibul Aziz,Md Omar Faruk

doi:10.3329/bjms.v20i1.50366

Abstract

Splenic cysts are rarely detected, and clinically diagnosed commonly as spleenomegaly . Thenature of the cyst could not be diagnosed pre-operatively because of its’ anatomical location andonly be confirmed by the histopathological assessments. These cysts are found as a sequel ofsplenic infarct followed by the abscess formation. This is a very rare condition of a minor boy ofonly 10 years’ old who presented with a hugely enlarged spleen. The common investigation(s)did not prove that it was in the haematological conditions. Ultrasonogram (USG) investigationshows spleenomegaly due to the cystic lesion. CT scan of the abdomen showed large andwell defined cystic mass which was 13.4cmX7.9cmX15.3cm in size, multi-loculated, septated,sharply demarcated as such well delineated cyst. After necessary preparation like vaccination,blood grouping, cross matching and other fitness, laparotomy and total spleenectomy was doneas the cyst occupied most of the Splenic tissue. The post operative recovery was uneventful andthe final diagnosis was confirmed by histopatholgical examinations as epidermoid cyst of thespleen. The patient was followed up for two consecutive months and not a single complicationwas noticed. Bangladesh Journal of Medical Science Vol.20(1) 2021 p.177-180

Highlights

The non-parasitic splenic cysts are very rare case
Epidermoid splenic cysts are the example of primary congenital cysts that contain an epithelial lining, unlike secondary cysts, which are composed of the fibrous tissues[1,2]
We are reporting a case of the large splenic epidermoid cyst - a very rare and very uncommon type of splenic cyst, which was removed by open spleenectomy totally highlighting the clinical presentation and the management option for such a kind of the patient in an economic poor resource setting in a larger portion of the population in Bangladesh

Summary

Introduction

The non-parasitic splenic cysts are very rare case. Splenic cysts are classified as primary cysts (true) or pseudocysts (secondary) on the basis of presence or absence of lining epithelium. Epidermoid splenic cysts are the example of primary congenital cysts that contain an epithelial lining, unlike secondary cysts, which are composed of the fibrous tissues[1,2]. It is due to lack of the typical as well as clinical presentation and they may be discovered very incidentally These should be differentiated from false or secondary cysts that they may result from trauma and contain serous or haemorrhagic fluid. We are reporting a case of the large splenic epidermoid cyst - a very rare and very uncommon type of splenic cyst, which was removed by open spleenectomy totally highlighting the clinical presentation and the management option for such a kind of the patient in an economic poor resource setting in a larger portion of the population in Bangladesh.

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Discussion

Conclusion