Spontaneous splenic pseudocyst: Case report of a rare entity

Abstract

Splenic cysts are classified on the basis of epithelial lining, either primary or secondary. Primary cysts are further divided as parasitic and nonparasitic. The secondary cysts are usually post traumatic or after a splenic extension of pancreatic pseudocyst. However, not all pseudocysts are associated with trauma. Mostly, they are asymptomatic (30%-60%) and usually grow in size to cause compressive symptoms. Splenic pseudocysts should be differentiated with other malignant and nonmalignant pathology, specifically hydatid cysts, in order to manage them correctly. The walls of pseudocysts may be degenerative or calcified, which may resemble hydatid cysts. Here, we present a case of a non-traumatic splenic cyst masquerading as a hydatid cyst preoperatively. The patient was taken up for surgery and intraoperatively noted to be a hemorrhagic cyst with a non-splenic cyst wall. We decided to preserve the spleen with marsupialisation of cyst and omentoplasty. On histopathology, the diagnosis of a pseudocyst of spleen was made in view of absent epithelial lining. We would like to report this case because of the diagnostic dilemma, its clinical rarity and, even more, in the absence of any history of trauma.

Large Splenic Cyst: a Case Report

“…Около 25% вторичных псевдокист селезенки имеют нетравматическую природу [7]. Они могут быть геморрагического, воспалительного или дегенеративного происхождения [4,8].…”

“…С использованием методов диагностической визуализации часто бывает трудно отличить первичную кисту селезенки от псевдокисты. Только гистопатологическое исследование является единственным способом («золотым стандартом») установить природу и этиологию кисты [7].…”

“…Хирургическим путем лечатся симптоматические кисты, а также те из них, размер которых превышает 5 см [7]. При этом используется частичная или тотальная спленэктомия, чрескожное дренирование, марсупиализация, или частичная цистэктомия.…”

A Giant Non-Traumatic Splenic Pseudocyst Successfully Treated With Cyst Aspiration and Partial Cystectomy: A Case Report and Review of Literature

“…Spleen cysts are rarely encountered in clinical practice [ 3 ]. Therefore, they present challenges for the surgeons in the work-up and the treatment [ 4 ].…”

“…The gold standard of treatment is splenectomy. Even so, partial splenectomy, percutaneous aspiration, and cystectomy are also described [ 3 ].…”