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Epidermoid Cyst of the Spleen

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

An Erratum to this article was published on 03 December 2013

Abstract

Background

The aim of this study is to elucidate the characteristics, clinical presentations, and management of epidermoid cysts located in the spleen and the intrapancreatic accessory spleen.

Methods

Data pooled for analysis were collected from epidermoid cyst cases encountered in the study institution and sporadic case reports obtained from the English literature.

Results

There were 115 cases of epidermoid cyst. Seventy eight (67.8 %) were found in the spleen, whereas 37 (32.2 %) were found in the intrapancreatic accessory spleen. Comparing between the two groups, the splenic group showed female predominance, younger age, and larger cystic size. For symptoms, left upper abdominal mass (57.7 %) and left upper abdominal pain (39.0 %) were more commonly found in the spleen group. Meanwhile, the intrapancreatic accessory spleen group had higher percentage of asymptomatic cysts (59.5 %). As for surgical indication, majority of patients in the spleen group underwent surgery for symptomatic relief (75.4 %), while the intrapancreatic accessory spleen group underwent surgery mainly for suspicious malignancy (90.0 %).

Conclusions

Surgical treatment for epidermoid cysts of the spleen is considered the optimal treatment for either alleviating the symptoms caused by a bulky cyst or for determining the histopathologic nature of a suspicious malignant cystic neoplasm.

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References

  1. Dan D, Bascombe N, Harnanan D, Hariharan S, Naraynsingh V. Laparoscopic management of a massive splenic cyst. Asian J Surg 2010; 33:103–6.

    Article  PubMed  Google Scholar 

  2. Maskey P, Rupakheti S, Regmi R, Adhikary S, Agrawal CC. Splenic epidermoid cyst. Kathmandu Univ Med J (KUMJ) 2007; 5:250–2.

    CAS  Google Scholar 

  3. Lam HB, Liu TP, Jeng KS. Huge splenic epidermoid cyst: a case report.Zhonghua Yi Xue Za Zhi (Taipei) 1997; 60:113–6.

    CAS  Google Scholar 

  4. Garfunkel F. Epidermoid cyst of the spleen: case report. J Nucl Med 1976; 17:196–9.

    PubMed  CAS  Google Scholar 

  5. Khashab MA, Canto MI, Singh VK, Hruban RH, Makary MA, Giday S. Endosonographic and elastographic features of a rare epidermoid cyst of an intrapancreatic accessory spleen. Endoscopy 2011; 43 Suppl 2:E193–4.

    Article  PubMed  Google Scholar 

  6. Hwang HS, Lee SS, Kim SC, Seo DW, Kim J. Intrapancreatic accessory spleen: clinicopathologic analysis of 12 cases. Pancreas 2011; 40:956–65.

    Article  PubMed  Google Scholar 

  7. Horn AJ, Lele SM. Epidermoid cyst occurring within an intrapancreatic accessory spleen. A case report and review of the literature. JOP 2011;12:279–82.

    PubMed  Google Scholar 

  8. Coleman WO. Epidermoid cyst of the spleen. Report of two cases. Am J Surg 1960; 100:475–9.

    Article  PubMed  CAS  Google Scholar 

  9. Itano O, Chiba N, Wada T, Yuasa Y, Sato T, Ishikawa H, Koyama Y, Matsui H, Kitagawa Y. Laparoscopic resection of an epidermoid cyst originating from an intrapancreatic accessory spleen: report of a case. Surg Today 2010; 40:72–5

    Article  PubMed  Google Scholar 

  10. Kadota K, Kushida Y, Miyai Y, Katsuki N, Hayashi T, Bando K, Shibuya S, Haba R. Epidermoid cyst in an intrapancreatic accessory spleen: three case reports and review of the literatures. Pathol Oncol Res 2010;16:435–42

    Article  PubMed  Google Scholar 

  11. Itano O, Shiraga N, Kouta E, Iri H, Tanaka K, Hattori H, Suzuki F, Otaka H. Epidermoid cyst originating from an intrapancreatic accessory spleen. J Hepatobiliary Pancreat Surg 2008;15:436–9

    Article  PubMed  Google Scholar 

  12. Malhotra A, Jones LT. Epidermoid cyst of the spleen. Pediatr Radiol 2008; 38:714.

    Article  PubMed  Google Scholar 

  13. Servais EL, Sarkaria IS, Solomon GJ, Gumpeni P, Lieberman MD. Giant epidermoid cyst within an intrapancreatic accessory spleen mimicking a cystic neoplasm of the pancreas: case report and review of the literature. Pancreas 2008; 36:98–100.

    Article  PubMed  Google Scholar 

  14. Omori S, Ishizaki Y, Kawasaki S. Image of the month. Epidermoid cyst of the spleen. Arch Surg 2007; 142:1009–10.

    Article  PubMed  Google Scholar 

  15. Tsujino T, Kogure H, Sasahira N, Isayama H, Tada M, Kawabe T, Omata M, Akahane M, Sano K, Makuuchi M. A huge intra-abdominal mass in a young man. Gut 2007; 56:1372

    Article  PubMed  CAS  Google Scholar 

  16. Theiler GJ. Epidermoid cyst of the spleen presenting as a pelvic mass. Report of a case. Arch Surg 1960; 81:591–2.

    Article  PubMed  CAS  Google Scholar 

  17. Ru K, Kalra A, Ucci A. Epidermoid cyst of intrapancreatic accessory spleen. Dig Dis Sci 2007; 52:1229–32.

    Article  PubMed  Google Scholar 

  18. Yigitbasi R, Karabicak I, Aydogan F, Erturk S, Bican O, Aydin O, Kantarci F. Benign splenic epithelial cyst accompanied by elevated Ca 19-9 level: a case report. Mt Sinai J Med 2006; 73:871–3.

    PubMed  Google Scholar 

  19. Kubo M, Yamane M, Miyatani K, Udaka T, Mizuta M, Shirakawa K. Familial epidermoid cysts of the spleen: report of two cases. Surg Today 2006; 36:853–6.

    Article  PubMed  Google Scholar 

  20. Kiriakopoulos A, Tsakayannis D, Papadopoulos S, Linos D. Laparoscopic management of a ruptured giant epidermoid splenic cyst. JSLS 2005; 9:349–51.

    PubMed  Google Scholar 

  21. Di Carlo I, Fasone MA, Toro A. Epidermoid cyst of the spleen in the laparoscopic era. Dig Surg 2005; 22:53–4.

    Article  PubMed  Google Scholar 

  22. Dibble JB, Weigent CE (1965) Epidermoid cyst of the spleen presenting as an abdominal emergency. Report of a case. JAMA 194:1144–6.

    Article  PubMed  CAS  Google Scholar 

  23. Kanazawa H, Kamiya J, Nagino M, Uesaka K, Yuasa N, Oda K, Arai T, Nishio H, Nimura Y. Epidermoid cyst in an intrapancreatic accessory spleen: a case report. J Hepatobiliary Pancreat Surg 2004; 11:61–3.

    Article  PubMed  Google Scholar 

  24. Arda IS, Tüzün M, Hicsönmez A. Epidermoid cyst of the spleen with elevated levels of CA125 and carcino-embryonic antigen. Eur J Pediatr 2005; 164:108.

    Article  PubMed  Google Scholar 

  25. Yano H, Asaoka T, Iwazawa T, Kinuta M, Monden T, Okamoto S. Hand-assisted laparoscopic splenectomy for a huge splenic cyst: operative technique and case report. J Laparoendosc Adv Surg Tech A 2003; 13:113–6.

    Article  PubMed  CAS  Google Scholar 

  26. Sonomura T, Kataoka S, Chikugo T, Hirooka T, Makimoto S, Nakamoto T, Sato M. Epidermid cyst originating from an intrapancreatic accessory spleen. Abdom Imaging 2002; 27:560–2.

    Article  PubMed  CAS  Google Scholar 

  27. Yokomizo H, Hifumi M, Yamane T, Hirata T, Terakura H, Murata K, Fujita H, Matsukane H. Epidermoid cyst of an accessory spleen at the pancreatic tail: diagnostic value of MRI. Abdom Imaging 2002; 27:557–9.

    Article  PubMed  CAS  Google Scholar 

  28. Fink AM, Kulkarni S, Crowley P, Crameri JA. Epidermoid cyst in a pancreatic accessory spleen mimicking an infected abdominal cyst in a child. AJR Am J Roentgenol 2002; 179:206–8.

    Article  PubMed  CAS  Google Scholar 

  29. Ito Y, Shimizu E, Miyamoto T, Taniguchi T, Nakajima K, Hara T, Kubosawa H. Epidermoid cysts of the spleen occurring in sisters. Dig Dis Sci 2002; 47:619–23.

    Article  PubMed  Google Scholar 

  30. Matsubayashi H, Kuraoka K, Kobayashi Y, Yokota T, Iiri Y, Shichijo K, Tada T, Satoh K, Kijima H. Ruptured epidermoid cyst and haematoma of spleen: a diagnostic clue of high levels of serum carcinoembryonic antigen, carbohydrate antigen 19-9 and Sialyl Lewis x. Dig Liver Dis 2001;33:595–9.

    Article  PubMed  CAS  Google Scholar 

  31. Horibe Y, Murakami M, Yamao K, Imaeda Y, Tashiro K, Kasahara M. Epithelial inclusion cyst (epidermoid cyst) formation with epithelioid cell granuloma in an intrapancreatic accessory spleen. Pathol Int 2001; 51:50–4.

    Article  PubMed  CAS  Google Scholar 

  32. Cowles RA, Yahanda AM. Epidermoid cyst of the spleen. Am J Surg 2000; 180:227.

    Article  PubMed  CAS  Google Scholar 

  33. Choi SK, Ahn SI, Hong KC, Kim SJ, Kim TS, Woo ZH, Shin SH. A case of epidermoid cyst of the intrapancreatic accessory spleen. J Korean Med Sci 2000; 15:589–92.

    PubMed  CAS  Google Scholar 

  34. Sakamoto Y, Yunotani S, Edakuni G, Mori M, Iyama A, Miyazaki K. Laparoscopic splenectomy for a giant splenic epidermoid cyst: report of a case. Surg Today 1999; 29:1268–72.

    Article  PubMed  CAS  Google Scholar 

  35. Baglaj M, Czernik J. Epidermoid cyst in a wandering spleen. Pediatr Surg Int 1998; 14:113–5.

    Article  PubMed  CAS  Google Scholar 

  36. Soares RL Jr, Balder DA, Migliori SJ, Amaral JF. Laparoscopic complete excision of a splenic epidermoid cyst. J Laparoendosc Adv Surg Tech A 1998; 8:237–40.

    Article  PubMed  Google Scholar 

  37. Furukawa H, Kosuge T, Kanai Y, Mukai K. Epidermoid cyst in an intrapancreatic accessory spleen: CT and pathologic findings. AJR Am J Roentgenol 1998; 171:271.

    Article  PubMed  CAS  Google Scholar 

  38. Higaki K, Jimi A, Watanabe J, Kusaba A, Kojiro M. Epidermoid cyst of the spleen with CA19-9 or carcinoembryonic antigen productions: report of three cases. Am J Surg Pathol 1998; 22:704–8.

    Article  PubMed  CAS  Google Scholar 

  39. Lippitt WH, Akhavan T, Caplan GE. Epidermoid cyst of the spleen with rupture and inflammation. Arch Surg 1967;95:74–8

    Article  PubMed  CAS  Google Scholar 

  40. Golinsky D, Freud E, Steinberg R, Zer M. Vertical partial splenectomy for epidermoid cyst. J Pediatr Surg 1995; 30:1704–5.

    Article  PubMed  CAS  Google Scholar 

  41. Zimmermann O, Schenken JR, Schultz L, Paustian FF. Epidermoid cyst of spleen, an unusual cause of massive splenomegaly. J Pediatr Surg 1972; 7:374–7.

    Article  PubMed  CAS  Google Scholar 

  42. Nakae Y, Hayakawa T, Kondo T, Shibata T, Kitagawa M, Sakai Y, Sobajima H, Ishiguro H, Tanikawa M, Nimura Y, et al. Epidermoid cyst occurring in a pancreatic accessory spleen. J Clin Gastroenterol 1991; 13:362–4

    Article  PubMed  CAS  Google Scholar 

  43. Younger KA, Hall CM. Epidermoid cyst of the spleen: a case report and review of the literature. Br J Radiol 1990; 63:652–3.

    Article  PubMed  CAS  Google Scholar 

  44. Bürrig KF. Epithelial (true) splenic cysts. Pathogenesis of the mesothelial and so-called epidermoid cyst of the spleen. Am J Surg Pathol 1988; 12:275–81.

    Article  PubMed  Google Scholar 

  45. Sullivan CA, Konefal SH Jr. Epidermoid cyst of the spleen successfully treated by marsupialization. Clin Pediatr (Phila) 1987; 26:203–5.

    Article  CAS  Google Scholar 

  46. Didlake RH, Miller RC. Epidermoid cyst of the spleen manifested as an abdominal abscess. South Med J 1986; 79:635–7.

    Article  PubMed  CAS  Google Scholar 

  47. Blank E, Campbell JR. Epidermoid cysts of the spleen. Pediatrics 1973; 51:75–84.

    PubMed  CAS  Google Scholar 

  48. Posener LJ, Litherland OK. An epidermoid cyst of the spleen. Can Med Assoc J 1956; 75:510–2.

    PubMed  Google Scholar 

  49. Radakovich M. Epidermoid cyst of the spleen; report of a case. Ann Surg 1950; 131:268–76,

    Article  PubMed  CAS  Google Scholar 

  50. Madia C, Lumachi F, Veroux M, Fiamingo P, Gringeri E, Brolese A, Zanus G, Cillo U, D’Amico DF. Giant splenic epithelial cyst with elevated serum markers CEA and CA 19-9 levels: an incidental association? Anticancer Res 2003; 23:773–6.

    PubMed  Google Scholar 

  51. Tsutsumi S, Kojima T, Fukai Y, Kanoh K, Shimura T, Mochiki E, Kato R, Asao T, Kuwano H. Epidermoid cyst of an intrapancreatic accessory spleen--a case report. Hepatogastroenterology 2000; 47:1462–4.

    PubMed  CAS  Google Scholar 

  52. LEWIS H. Epidermoid cyst of the spleen. Am J Surg 1960; 99:242–3.

    Article  PubMed  CAS  Google Scholar 

  53. Shirkhoda A, Freeman J, Armin AR, Cacciarelli AA, Morden R. Imaging features of splenic epidermoid cyst with pathologic correlation. Abdom Imaging 1995; 20:449–51.

    Article  PubMed  CAS  Google Scholar 

  54. Lifschitz-Mercer B, Open M, Kushnir I, Czernobilsky B. Epidermoid cyst of the spleen: a cytokeratin profile with comparison to other squamous epithelia. Virchows Arch 1994; 424:213–6.

    Article  PubMed  CAS  Google Scholar 

  55. Nerlich A, Permanetter W. Fine needle aspiration cytodiagnosis of epidermoid cysts of the spleen. Report of two cases. Acta Cytol 1991; 35:567–9.

    CAS  Google Scholar 

  56. Rathaus V, Zissin R, Goldberg E. Spontaneous rupture of an epidermoid cyst of spleen: preoperative ultrasonographic diagnosis. J Clin Ultrasound 1991; 19:235–7.

    Article  PubMed  CAS  Google Scholar 

  57. Panossian DH, Wang N, Reeves CD, Weeks DA. Epidermoid cyst of the spleen presenting as a generalized peritonitis. Am Surg 1990; 56:295–8.

    PubMed  CAS  Google Scholar 

  58. Ahlgren LS, Beardmore HE. Solitary epidermoid splenic cysts: occurrence in sibs. J Pediatr Surg 1984; 19:56–8.

    Article  PubMed  CAS  Google Scholar 

  59. Arnold J, McGahan JP, Stadalnik RC. Epidermoid cyst of the spleen: value of noninvasive imaging modalities in preoperative diagnosis. J Comput Assist Tomogr 1982; 6:836–8.

    Article  PubMed  CAS  Google Scholar 

  60. Davidson ED, Campbell WG, Hersh T. Epidermoid splenic cyst occurring in an intrapancreatic accessory spleen. Dig Dis Sci 1980; 25:964–7.

    Article  PubMed  CAS  Google Scholar 

  61. Glancy JJ. Fluid-filled echogenic epidermoid cyst of the spleen. J Clin Ultrasound 1979; 7:301–2.

    Article  PubMed  CAS  Google Scholar 

  62. Ross ME, Elwood R, Yang SS, Lucas RJ. Epidermoid splenic cysts. Arch Surg 1977; 112:596–9.

    Article  PubMed  CAS  Google Scholar 

  63. Morag B, Griffel B. Huge epidermoid cyst of the spleen. Int Surg 1975; 60:496–7.

    PubMed  CAS  Google Scholar 

  64. Tsakraklides V, Hadley TW. Epidermoid cysts of the spleen. A report of five cases. Arch Pathol 1973; 96:251–4.

    PubMed  CAS  Google Scholar 

  65. Motosugi U, Yamaguchi H, Ichikawa T, Sano K, Araki T, Takayama Y, Shimizu K, Hatori T, Shiratori K, Koyama I, Shimizu M. J Epidermoid cyst in intrapancreatic accessory spleen: radiological findings including superparamagnetic iron oxide-enhanced magnetic resonance imaging. Comput Assist Tomogr 2010; 34:217–22.

    Article  Google Scholar 

  66. Ough YD, Nash HR, Wood DA. Mesothelial cysts of the spleen with squamous metaplasia. Am J Clin Pathol 1981; 76:666–669.

    PubMed  CAS  Google Scholar 

  67. Kalayci M, Akyüz U, Demırağ A, Ozkan F, Gökçe O. Huge congenital epidermoid spleen cyst in an adult. Turk J Gastroenterol 2012; 23:421–423.

    PubMed  Google Scholar 

  68. Fragandreas G, Papadopoulos S, Gerogiannis I, Spyridis C, Tsantilas D, Venizelos I, Gerasimidis T. Epithelial splenic cysts and life-threatening splenic rupture. Chirurgia (Bucur) 2011; 106:519–522.

    CAS  Google Scholar 

  69. Fan H, Zhang D, Zhao X, Pan F, Jin ZK. Laparoscopic partial splenectomy for large splenic epidermoid cyst. Chin Med J 2011; 124:1751–1753.

    PubMed  Google Scholar 

  70. Del Sordo R, Bellezza G, Colella R, Mameli MG, Giansanti M, Cavaliere A. Epithelial cyst of the spleen with foci of ectopic liver. J Pediatr Surg 2011; 46:e21–23.

    Article  PubMed  Google Scholar 

  71. Hu S, Zhu L, Song Q, Chen K. Epidermoid cyst in intrapancreatic accessory spleen: computed tomography findings and clinical manifestation. Abdom Imaging 2012; 37:828–833.

    Article  PubMed  Google Scholar 

  72. Harris AC, Chaudry MA, Menzies D, Conn PC. Laparoscopic resection of an epidermoid cyst within an intrapancreatic accessory spleen: a case report and review article. Surg laprosc Endosc Percutan Tech 2012; 22:e246–249.

    Article  Google Scholar 

  73. Urakami A, Yoshida K, Hirabayashi Y, Kubota H, Yamashita K, Hirai T, Tsunoda T. Laparoscopy-assisted spleen-preserving pancreatic resection for epidermoid cyst in an intrapancreatic accessory spleen. Asian J Endosc Surg 2011; 4:185–188.

    Article  PubMed  CAS  Google Scholar 

  74. Iwasaki Y, Tagaya N, Nakagawa A, Kita J, Imura J, Fujimori T, Kubota K. Laparoscopic resection of epidermoid cyst arising from an intrapancreatic accessory spleen: a case report with a review of the literature. Surg Laparosc Endosc Percutan Tech 2011; 21:e275–279.

    Article  PubMed  Google Scholar 

  75. Pitiakoudis M, Zezos P, Oikonomou A, Laftsidis P, Kouklakis G, Simopoulos C. Total Splenectomy due to an Unexpected “Complication” after Successful Extended Laparoscopic Partial Decapsulation of a Giant Epidermoid Splenic Cyst: A Case Report. Case Report Med 2011; 2011:318208.

    Google Scholar 

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Correspondence to Shin-E Wang.

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Chen YY and Wang SE equally contributed to this paper.

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Chen, YY., Shyr, YM. & Wang, SE. Epidermoid Cyst of the Spleen. J Gastrointest Surg 17, 555–561 (2013). https://doi.org/10.1007/s11605-012-2088-y

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