Diagnosis and Management of a Rare Splenic Cyst

Splenic cysts are rare and are often detected incidentally or until the cyst reaches a certain size, causing clinical symptoms. They are classified into primary (true) and secondary (false) splenic cysts. False cysts often pose diagnostic and therapeutic challenges due to their nonspecific clinical presentation and overlapping imaging features with true cysts. Here, we present the case of a 36-year-old female who presented with symptoms of intermittent left-sided abdominal pain, nausea, loss of appetite, and low-grade fever. Clinical examination revealed a palpable mass in the left hypochondrium. Contrast-enhanced computed tomography showed a large, well-defined cystic lesion arising from the inferior pole of the spleen. Based on clinical, serological, cytological, and radiological findings, a nonparasitic splenic cyst was suspected preoperatively. As the cyst was large (>8 cm) and involved >75% of the splenic parenchyma, a total splenectomy was performed. Histopathological examination revealed the absence of an epithelial lining, confirming a nonparasitic secondary (false) splenic pseudocyst. The postoperative course was uneventful. A systematic diagnostic workup and total splenectomy remain safe and effective options for splenic cysts with significant size and rupture risk. Histopathological examination continues to be the gold standard for definitive diagnosis.