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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
 
BMJ Case Rep. 2010; 2010: bcr0620103125.
Published online Nov 2, 2010. doi:  10.1136/bcr.06.2010.3125
PMCID: PMC3029511
Reminder of important clinical lesson
Primary epithelial splenic cyst with micro-rupture and raised carbohydrate antigen CA 19-9: a proposal for management
Iordanis N Papadopoulos, Anastasios Davatzikos, Georgios Kasabalis, Christina Manti, and Georgios Konstantoudakis
Fourth Surgery Department, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
Correspondence to Iordanis N Papadopoulos, ipapado/at/med.uoa.gr
Abstract
Background
Epithelial splenic cysts are rare entities which surgeons may not have previously encountered. Their management is based on historical studies.
Case presentation
A 21-year-old woman presented with a cyst of the spleen that produced a high serum concentration of carbohydrate antigen CA 19-9. A partial splenectomy with removal of the entire cyst and preservation of the splenic parenchyma by laparotomy was performed and the patient made an uneventful recovery. A microscopic rupture of the wall of the cyst and blood degradation products in the fluid of the cyst were confirmed. A functional splenic parenchyma was documented 18 months after surgery. There was no infection during follow-up.
Conclusion
Partial surgical splenectomy with resection of the entire cyst prevents recurrence and preserves splenic function.
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