Giant epidermoid cyst of the spleen in a pediatric patient

Esposito, Susanna; Leonardi, Alberto; Penta, Laura; Prestipino, Marco; Bertozzi, Mirko

doi:10.1097/md.0000000000015653

Cited by 10 publications

(23 citation statements)

References 15 publications

(19 reference statements)

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“…Furthermore, the objective of resection of the splenic cyst should be local exeresis of the cyst, preserving as much splenic parenchymal mass as possible or even the entire spleen in order to prevent the complications of asplenia, which was the attitude in our case. Partial open splenectomy has been proven safe and effective [13]. Surgical resection is performed with the risk of infection (e.g.…”

Section: Discussionmentioning

confidence: 99%

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An Uncommon Cystic Mass of the Spleen in a Child

Zaari¹,

Miri²,

Ammor³

et al. 2020

CCR

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Splenic cysts are extremely rare, particularly in pediatric population. They may be parasitic or non-parasitic in origin. The parasitic splenic cysts, usually caused by Echinococcus granulosus, account for 60% of all primary splenic cysts. The primary epithelial cysts or epidermoid cysts account for 10% of all splenic non-parasitic cysts. We report a case of epidermoid cyst of spleen in a 13-years-old boy admitted with an abdominal pain, which on imaging found to be a cystic mass arising from spleen. On laparotomy the spleen was found occupying a major part of the abdomen. Open partial splenectomy was performed. The post-operative clinical course was satisfactory and uneventful. Histopathological examination revealed it to be a primary epithelial cyst of spleen. This case report emphasises on the rarity of the case at this age.

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Section: Discussionmentioning

confidence: 99%

“…Also if there is anatomical variations in the splenic hilar vasculature. When the main splenic artery is long and divides near the hilum, partial splenectomy is more and more difficult [13].…”

Section: Discussionmentioning

confidence: 99%

An Uncommon Cystic Mass of the Spleen in a Child

Zaari¹,

Miri²,

Ammor³

et al. 2020

CCR

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“…Дослідження розмірів селезінки в динаміці показало значне зниження в 1,6 раза (р<0,05) розмірів після хірургічного лікування: зі 168,00 [99,84; 277,00] см 3 3 , після -189 см 3 . Значне збільшення (у 2,07 раза -з 58 см 3 до 121 см 3 ) також було в пацієнта Б., 9 років, із кістою в нижньому сегменті, операція «Лапаротомна сегментарна резекція селезінки».…”

Section: результати дослідження та їх обговоренняunclassified

“…Ще донедавна єдиним вирішенням хірургічного лікування КС була спленектомія [13]. Модернізація хірургічної техніки, поява високотехнологічної електрохірургії, наявніс ть с у часного ат равматичного розсмоктуючого та нерозсмоктуючого шовного матеріалу, використання різноманітних зшивальних апаратів і вдосконалення хірургічного досвіду відкрили органозберігаючу еру в медицині [3,6,12].…”

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Results of surgical correction or conservative management of splenic cysts in children according to remote monitoring changes

Kuzyk¹,

Prytula²,

Krivchenya³

et al. 2022

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Treatment of splenic cysts (SC) in children is variable and controversial. Depending on the size and location of these formations in the spleen, surgical correction is possible in open or laparoscopic surgery, or conservative (non-invasive) management. The result of SC treatment should be the complete elimination of the cyst cavity. Purpose - to evaluate the results of surgical correction or conservative management of CS in children according to remote monitoring changes. Materials and methods. We conducted the study on 265 children aged 0-17 years (mean age 11.25±4.21 years), who were examined and treated for SC. One hundred seventy-five (66.04±2.91%) children underwent surgery, and 90 (33.96±2.91%) patients received conservative treatment. We subjected all the information recorded in the medical records to statistical processing. The mentioned information could characterize the situation with the treatment process and with dynamic monitoring of this pathology to some extent. Results. The most common localizations of cysts were the upper (33.21±2.89%) or middle segments of the spleen (29.81±2.81%). Almost every fourth patient (27.92±2.76%) with SC had pathology of other organs or systems, and every tenth (9.81±1.83%) had other diseases of the spleen. We detected residual cyst in 46.42±3.06% of patients; it underwent complete regression within 1-3 years. Residual cyst of small size (which persisted after surgical correction) regressed much faster after surgery compared with regression of cystic formation of small size in the spleen with conservative management (p<0.05). Conclusions. Therapeutic tactics for SC in children involve different options for individual surgical correction or conservative management, depending on the location, size, relationship to the architecture of the main vessels and the variant of damage to the parenchyma of the spleen. The outcome of treatment of children with SC depends on the volume, location, etiology of the lesion, the method of correction and compliance with all recommendations in the postoperative period against the background of comorbidities. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: splenic cyst, children, surgical treatment, conservative management, results.

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“…Більшість пацієнтів насторожено сприймають наявність будьякого кістозного або пухлиноподібного утворення в селезінці, тому їх усвідомленість щодо лікувальної тактики також є важливою. Погляди хірургів щодо лікувальної тактики при КС різних розмірів радикально різняться, так само, як і принципи хірургічного лікування (лапароскопічно або відкрито) [2,4,9]. Окремими питаннями є показання і методика консервативного (неінвазивного) ведення (спостереження) пацієнтів із КС [1,5,7,12].…”

Section: ϯϳunclassified

Conservative (non-invasive) management of children with splenic cysts

Prytula¹,

Krivchenya²,

Kuzyk³

et al. 2021

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Surgeons’ views on tactics for treatment of splenic cysts (SC) in children are widely discussed in the literature. Indications and methods of conservative (non-invasive) management (observation) of children with SC is different issue. Purpose – to develop rational tactical approache for conservative (non-invasive) management of children with SC. Materials and methods. A retrospective analysis of conservative (non-invasive) management of 90 (33.96%) of 265 patients with SC was performed. Children were not operated if the SC was less than 20 mm (n=61) in diameter. They were first monitored by ultrasound 2 times for 6 months, then – 2 times a year, until puberty. We did not observe the progression of cyst growth in these children. Also did not operate children in whom the size of SC was from 20 to 62 mm, had an asymptomatic course and parents did not consent to surgical treatment (n=29). This is the most difficult group of patients to analyze, as most of them lack information about the dynamic observation. According to the results of dynamic observation in 19 of 29 examined patients’ regression of SC was not observed, which later served as an indication for surgical treatment. Results and conclusions. In the presence of SC, a choice of surgical treatment or conservative (non-invasive) management is possible. Tactical approach for treatment of children with SC is strictly individual and depends on the size and location of the parenchymal lesion. In SC up to 20 mm diameter, conservative (non-invasive) management is rational, which is confirmed by the lack of progression of cyst growth in these children. Dynamic observation of patients with SC with a diameter of more than 20 mm without regression, serves as an indication for surgical treatment. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: spleen cyst, children, conservative, non-invasive, management, results.

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Giant epidermoid cyst of the spleen in a pediatric patient

Cited by 10 publications

References 15 publications

An Uncommon Cystic Mass of the Spleen in a Child

An Uncommon Cystic Mass of the Spleen in a Child

Results of surgical correction or conservative management of splenic cysts in children according to remote monitoring changes

Conservative (non-invasive) management of children with splenic cysts

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