Burnt out benign splenic cyst mimicking intra-abdominal malignancy - case report and review of literature.pdf

The spleen performs important immunological function. Benign cysts, neoplasms and abscesses are identifiable cystic lesions of the spleen. Splenic cysts are very rare, and consist of Type 1 (parasitic) and Type 11 (non-parasitic) cysts. Very few cases of huge splenic cysts have been reported in literature. The most common symptoms are due to pressure effects on contiguous organs, causing pain, abdominal swelling and change in bowel habit. Management of these splenic cysts iscontroversial. Indications for surgical intervention, include symptomatic or large diameter cysts (>5cm). We report a 57 year old lady with an 18 year history of recurrent left abdominal pain, progressive weight loss, easy satiety, and recurrent low grade fever. She neither had change in bowel habit, nor haematuria. Therewas no history of abdominal trauma. On physical examination, there was a left hypochondriac swelling, extending to the midline of the abdomen. She has been transfusedseverally in the past on account of recurrent anaemia. Ultrasound revealed multiple well circumscribed oval and rounded cysts of the spleen. Her haemoglobin level at presentation was 6g/dl. She had neutrophilia. She subsequently underwent total splenectomy with good surgical outcome.