Total laparoscopic splenectomy for giant epidermoid cyst: a case report

Area of Science:

• Surgical oncology
• Gastroenterology
• Abdominal imaging

Background:

• Splenic cysts are benign tumors often found incidentally via imaging (US, CT).
• They are categorized as true cysts (25%) or pseudocysts (75%).
• Traditional treatment for large or complicated splenic cysts involves splenectomy (open or laparoscopic).

Observation:

• A 46-year-old martial artist presented with left upper quadrant pain and a 12 cm giant splenic mass.
• Imaging (US, CT, MRI) confirmed a large oval mass in the superior splenic pole, suspected to be a cyst.
• Given the patient's history of thoraco-abdominal trauma, total laparoscopic splenectomy was chosen.

Findings:

• The laparoscopic splenectomy was successfully completed using a three-trocar technique in 150 minutes.
• Post-operative recovery was uneventful, with drain removal on the 4th day and discharge on the 5th.
• Pathological examination confirmed the splenic mass to be an epidermoid cyst.

Implications:

• Total laparoscopic splenectomy is a viable and safe option for managing giant splenic cysts.
• This minimally invasive approach may offer benefits in recovery for patients with symptomatic or complicated splenic cysts.
• Further research can explore long-term outcomes and comparisons with partial splenectomy techniques.