Primary Epithelial Splenic Cyst in a Boy: Laparoscopic Management

Abstract

Splenic cysts are a rare condition, with an incidence of only 0.07%, and there have been approximately 800 reported cases in the English literature to date. These cysts can be classified as primary or secondary, depending on whether they have an epithelial lining. They can also be categorized as parasitic or non-parasitic in origin. Primary cysts are also known as true, congenital epithelial, or epidermoid cysts and account for about 10% of all benign, non-parasitic splenic cysts.     They are the most common type of splenic cyst in children. Typically, splenic cysts are asymptomatic and are often discovered incidentally during imaging studies or during surgery. Symptoms associated with splenic cysts are generally related to the size of the cyst. When these cysts grow large, they may cause sensations of fullness in the left abdomen, splenomegaly (enlargement of the spleen), local or referred pain, or in rare cases, thrombocytopenia (low platelet count). Complications can also arise, such as infection, rupture, and haemorrhage. The preoperative diagnosis of primary splenic cysts is typically made using imaging techniques like ultrasonography, CT scans, and MRI scans. However, a careful histopathological evaluation, along with immunostaining to confirm the presence of an epithelial lining, is essential to arrive at a definitive diagnosis. We would like to present the case of a 13-year-old boy who came to us with an abdominal lump and associated pain that had persisted for one month. Ultrasonography and a CT scan of the abdomen revealed a unilocular cyst measuring 8x7x6 cm, originating from the upper pole of the spleen. To address this, we performed a partial cystectomy, marsupialization, and omentoplasty to manage the condition.