Epidermoid cyst of the spleen presenting as a generalized peritonitis

In this report we reviewed 159 cases of epidermoid cyst of the spleen reported since 1929 and we added one case of our own with a unique clinical presentation. In these cases, the patients' age at presentation ranged from newborn to 51 years, with a mean age of 17.7 years. Female-to-male ratio was 2.0 to 1.0. Patients with this lesion usually present with asymptomatic abdominal mass and/or abdominal pain. Only in rare reports has there been infection (4 cases) or rupture (4 cases) of the cyst. In our case, the patient presented with an acute surgical abdomen and diffuse peritonitis. As in three of the previously reported cases associated with infection, Salmonella group organisms were cultured from the cyst abscess. Splenectomy is the surgical treatment of choice and the initial antibiotic regime should include Salmonella coverage.