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BMJ Case Rep. 2010; 2010: bcr0620103125.
Published online 2010 November 2. 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

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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