Abstract
Introduction: Cystic lesions of the spleen are infrequent and usually diagnosed incidentally. These lesions are rare and their differential diagnosis is very wide. Splenic epithelial cysts are the most common type of primary splenic cyst (4%). Surgical treatment is indicated for cysts larger than 5 cm or symptomatic. Nowadays, spleen preserving surgery is the gold standard treatment considering the immunologic role of the spleen and the increased risk of post-splenectomy infections.Case presentation: A 17 year old girl presented to the outpatient clinic with moderate left upper quadrant abdominal pain of 2 weeks duration with loss of appetite and denied fever, chills, sweating and jaundice. Abdominal examination showed tender splenomegaly. The abdominal imaging (Ultrasound, CT SCAN, MRI) was suggestive of hydatid cyst of the spleen, for which she received Albendazole for 1 month and then operated by laparotomy with partial resection and un-roofing of the splenic cyst. The pathology report showed a splenic epithelial cyst (SEC).Conclusion: SEC is a rare pathology that could mimic splenic hydatid cyst. The clinical and radiological pictures may be commonly misleading and non-conclusive. Definitive diagnosis is made on histopathology. Spleen conserving surgery, when possible, is the preferred modality for treatment.
Highlights
Cystic lesions of the spleen are infrequent and usually diagnosed incidentally
Splenic cystic lesions are uncommon entity with an incidence rate of 0.07% reported in a review of 42,327 autopsies [1]
They are classified into true and false cysts based on the presence of cellular epithelial lining [2].True or primary cysts are epitheliumlined cysts and represent 25% of all splenic cysts
Summary
Splenic cystic lesions are uncommon entity with an incidence rate of 0.07% reported in a review of 42,327 autopsies [1] They are classified into true and false cysts based on the presence of cellular epithelial lining [2].True or primary cysts are epitheliumlined cysts and represent 25% of all splenic cysts. The clinical presentation is nonspecific and it varies from asymptomatic occurrence to symptoms related to the size, location and the presence of cyst complications [5] Diagnostic imaging modalities such as abdominal ultrasound, scan and MRI demonstrate the splenic cyst but are unable to differentiate SEC from other types of primary splenic cyst such as parasitic and neoplastic [5,6]. This work has been reported in line with the SCARE criteria [7]
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