1
|
Kong M, Chen S, Bai Y, Yan Y, Yi M, Wang M, Liu H, Jia J, Liu C, Zhang S. Transumbilical single-site laparoscopic treatment of primary splenic cyst in child: a rare case report and review of literature. Front Pediatr 2024; 12:1454487. [PMID: 39386018 PMCID: PMC11461222 DOI: 10.3389/fped.2024.1454487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Accepted: 09/16/2024] [Indexed: 10/12/2024] Open
Abstract
Background Splenic cysts are relatively rare benign tumors that are asymptomatic in most patients and are usually discovered incidentally by imaging. In our case, we report a splenic cyst in a child who underwent laparoscopic partial splenectomy. Case description A 13-year-old boy was admitted to the hospital after an incidental finding of a splenic cyst on an abdominal ultrasound conducted 4 days prior. He was asymptomatic before admission. Upon admission, abdominal ultrasound and CT revealed a cystic lesion in the spleen, highly suspicious for a splenic cyst. Then, we used transumbilical single-site laparoscopic exploration and found a cyst measuring approximately 12 cm × 11 cm × 10 cm at the upper pole of the spleen, so we performed a partial splenectomy and diagnosed a primary epithelioid splenic cyst via postoperative pathology. Conclusions Splenic cysts in children are very rare and can be treated conservatively in asymptomatic patients with a diameter of less than 5 cm, while surgery is required in symptomatic patients or those with a diameter greater than or equal to 5 cm. Transumbilical single-site laparoscopic partial splenectomy is a minimally invasive and effective treatment, especially for children.
Collapse
Affiliation(s)
- Meng Kong
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| | - Shuai Chen
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| | - Yuexia Bai
- Department of Pathology, Children’s Hospital Affiliated to Shandong University, Jinan, China
| | - Yuxi Yan
- Department of Ultrasound, Children’s Hospital Affiliated to Shandong University, Jinan, China
| | - Minggang Yi
- Department of Radiology, Children’s Hospital Affiliated to Shandong University, Jinan, China
| | - Meiyun Wang
- Child Health Department, Children’s Hospital Affiliated to Shandong University, Jinan, China
| | - Hongzhen Liu
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| | - Jinhua Jia
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| | - Chuanyang Liu
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| | - Shisong Zhang
- Department of Pediatric Surgery, Children’s Hospital Affiliated to Shandong University, Jinan, China
- Department of Pediatric Surgery, Jinan Children’s Hospital, Jinan, China
| |
Collapse
|
2
|
Gomez DM, Sivaganesh S. Large epidermoid cyst of the spleen causing massive splenomegaly: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241239530. [PMID: 38486974 PMCID: PMC10938603 DOI: 10.1177/2050313x241239530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
Splenic cysts are uncommon and are classified as primary cysts or secondary cysts based on the presence or absence of an intact epithelial lining, respectively. Epidermoid cysts have an epithelial lining of stratified squamous epithelium and have been reported in normal and intra-pancreatic accessory spleens. An 18-year-old girl presented with a symptomatic, uncomplicated splenic cyst causing massive splenomegaly and symptoms due to mass effect. Peripheral cytopaenias and lymphoproliferative neoplasm were excluded. Preoperative computed tomography was suggestive of a large splenic cyst causing massive splenomegaly and marked loco-regional pressure effects. Open splenectomy was performed and histology confirmed an epidermoid cyst with no features of malignancy. Splenic epidermoid cysts are a rare cause of massive splenomegaly. Surgical intervention is recommended due to symptoms and the risk of complications.
Collapse
Affiliation(s)
- Deshan Mario Gomez
- The University Surgical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Sivasuriya Sivaganesh
- Division of HPB Surgery, Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| |
Collapse
|
3
|
Alharbi R, Almohammdi R, Alharbi W, Alshaikhjafar F, Alharbi A. A Case Report of a Large Splenic Cyst in a Pediatric Patient. Cureus 2023; 15:e46113. [PMID: 37900502 PMCID: PMC10612122 DOI: 10.7759/cureus.46113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Splenic cysts in the pediatric population are rare but can present with a range of clinical manifestations. Acute abdominal pain, although uncommon, is a significant presentation that requires prompt evaluation and management. We present the case of an 11-year-old female who presented to the emergency department with severe left upper quadrant abdominal pain of 24 hours' duration. Physical examination revealed tenderness and guarding in the left upper quadrant with a palpable, firm mass. Elevated serum amylase and lipase levels initially raised suspicion of a pancreatic etiology, but further investigations confirmed the presence of a large cystic lesion in the spleen. The patient underwent laparoscopic splenectomy, and the resected specimen confirmed a benign splenic cyst. Postoperatively, she recovered uneventfully and was discharged with appropriate follow-up plans. This case report underscores the importance of early recognition and prompt surgical intervention in managing splenic cysts in pediatric patients. The diverse etiologies and pathophysiological mechanisms of splenic cysts necessitate a comprehensive diagnostic approach.
Collapse
Affiliation(s)
- Rawan Alharbi
- Medicine, Jordan University of Science and Technology, Irbid, JOR
| | | | | | | | - Ahlam Alharbi
- Family Medicine, Primary Health Care Center, Riyadh, SAU
| |
Collapse
|
4
|
Hammouda SB, Mabrouk S, Bellalah A, Maatouk M, Zakhama A, Njim L. Large splenic epithelial cyst: A rare presentation. Int J Surg Case Rep 2022; 95:107201. [PMID: 35594788 PMCID: PMC9121251 DOI: 10.1016/j.ijscr.2022.107201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Splenic cysts are infrequent and most of them are related to parasitic diseases. Splenic epithelial cyst (SEC) is the most common type of primary non-parasitic splenic cysts. Its pathogenesis is not yet clear. Splenic cysts are usually asymptomatic and are detected incidentally during imaging exams or an exploratory laparotomy. CASE PRESENTATION Our case is about a primary SEC discovered incidentally. An 18-year-old male patient without any personal and family medical history, presented with symptoms of upper urinary tract infection. Renal ultrasound was performed and found incidentally a solitary cystic lesion in the spleen. A laparoscopic partial splenectomy was made then. The specimen was sent for pathological examination and a diagnosis of primary (epidermoid) epithelial splenic cyst was given. CLINICAL DISCUSSION SEC is a rare pathology that could mimic other splenic cysts like hydatid cyst. The preoperative diagnosis of SEC can be suspected by ultrasonography, computed tomography or magnetic resonance imaging. However, histopathological examination is mandatory to confirm the diagnosis. A wide range of differential diagnoses is considered when we suspect clinically SEC because of its lower incidence. CONCLUSION Actually, spleen-preserving surgery with minimally invasive methods such as laparoscopy is the gold standard for the treatment of SEC despite the risk of recurrence encountered with these techniques. However, different surgical modalities are discussed depending on the size and the location of the cyst and the patient's age.
Collapse
Affiliation(s)
- Seifeddine Ben Hammouda
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia.
| | - Samiha Mabrouk
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| | - Ahlem Bellalah
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| | - Mezri Maatouk
- Department of Radiology, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| | - Abdelfatteh Zakhama
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| | - Leila Njim
- Department of Pathology, Fattouma Bourguiba University Hospital, Monastir 5000, Tunisia; Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| |
Collapse
|