Spontaneous regression of a true splenic cyst: a case report and review of the literature

Abstract

Splenic cysts are rare clinical findings, detected due to derivative symptoms or as a random discovery in abdominal imaging. Although there still remains controversy as to their optimal treatment, bigger secondary cysts should be treated surgically. However, spontaneous regression may be observed in cysts with a diameter smaller than 4 cm. In these cases, expectant treatment is preferable. We report, herein, a single case of a splenic cyst in an adult woman, who reported minor symptoms despite the size of the lesion and who demonstrated a possible almost total regression of the cyst within a ten-year period, accompanying with review of the most recent literature.

Pseudocyst of Spleen; An Uncommon Clinical Entity, although Common Theoretically

“…Localization, size and type of the cyst are the factors to make them symptomatic. It is accepted generally that a cyst with a diameter more than 4 cm will be symptomatic, although there is no consensus on this (7). The diameter of the cysts were over 4 cm in both of our cases.…”

“…Splenectomy was the operation for all types of lesions in the past, but more conservative solutions are suggested currently because the immunological functions of the spleen is better understood and it is obvious that the risk of sepsis increases after splenectomy. Total splenectomy is suggested only for huge cysts, as well as cysts covered with splenic parenchyma or cysts located on splenic hylus (7). Partial splenectomy may be the procedure for cysts which are not so large or the ones located on superior or inferior pole, and for the cases that bleeding is not a problem.…”

A Splenic Epithelial Cyst: Increased Size, Exacerbation of Symptoms, and Elevated Levels of Serum Carcinogenic Antigen 19-9 after 6-year Follow-up

“…5 cm (17,19). Observation is recommended for small, asymptomatic cyst (17), as spontaneous regression can be expected (20). However, this agreement is based on the facility of surgical treatment, rather than solid data.…”

“…However, this agreement is based on the facility of surgical treatment, rather than solid data. According to recent reviews, the incidence of overall complications in cases of splenic epithelial cysts was 5.2-8.5% (21,22), and ruptured cysts ranged in size from 5.5 cm to 15 cm or more (20,23,24). In an analysis of 23 splenic epithelial cysts, the average size was 14.3 cm (range: 1-25 cm), and none of the cysts were associated with complications, including rupture and infection (17).…”

Pseudocyst of the spleen: Report of two cases

“…Međutim postojanje takozvanih post-traumatskih cista je bilo predmet ispitivanja Burriga i Morgensterna 7 . Prema Burrigu osustvo epitelnog zida može biti lažno zapažanje isto kao što se u epitelnim cistama može naići na polja bez epeitela 8 .…”