Primary epithelial splenic cyst with micro-rupture and raised carbohydrate antigen CA 19-9: a paradigm of management

Epithelial splenic cysts are rare entities that surgeons might not have previously encountered and their management is based on historical studies. A 21-year-old female presented with a cyst of the spleen that produced a high serum concentration of carbohydrate antigen CA 19-9. A partial splenectomy with the removal of the entire cyst and preservation of splenic parenchyma by laparotomy was performed and the patient made an uneventful recovery. A microscopic rupture of the wall of the cyst and degradation of blood in the fluid of the cyst were confirmed. Eighteen months following surgery a functional splenic parenchyma was documented. There was no episode of infection during this follow-up time. Partial surgical splenectomy with resection of the entire cyst prevents recurrence and preserves splenic function.