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[Total splenectomy for a recurrent giant splenic cyst]
M Casaccia1, L Saltalamacchia, F Panaro
1Università degli Studi di Genova, Ospedale S. Martino, Dipartimento Trapianti, Divisione di Chirurgia Generale e dei Trapianti d'Organo.
Il Giornale Di Chirurgia
|April 5, 2005
Summary
Recurrent huge splenic cysts, often epithelial, may require complete surgical removal. Marsupialization is frequently ineffective, highlighting the need for complete cyst wall resection to prevent recurrence.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Primary splenic cysts are rare, with large ones often necessitating surgical intervention.
- Recurrence can occur, especially after less invasive procedures.
Observation:
- A 41-year-old female presented with a recurrent, huge splenic cyst (20 cm diameter).
- Previous marsupialization 6 years prior had been performed.
- Imaging confirmed a large cystic splenic lesion.
Findings:
- Total open splenectomy was performed with an uneventful postoperative course.
- Histologic diagnosis confirmed an epithelial cyst of the spleen without atypical cells.
- The cyst wall was previously identified as epidermal.
Implications:
- Complete resection of the cyst wall is crucial for preventing recurrence of splenic epithelial cysts.
- Techniques like partial splenectomy or "peeling" the cyst off the parenchyma may preserve splenic tissue.
- Marsupialization is often an ineffective treatment for these large, recurrent cysts.