Advertisement

Journal of Gastrointestinal Surgery

, Volume 18, Issue 9, pp 1658–1663 | Cite as

Management of Non-Parasitic Splenic Cysts: Does Size Really Matter?

  • Christopher D. Kenney
  • Yumiko E. Hoeger
  • Amy K. Yetasook
  • John G. Linn
  • Ervin W. Denham
  • Joann Carbray
  • Michael B. UjikiEmail author
2014 SSAT Poster Presentation

Abstract

Background

Splenic cysts are relatively rare clinical entities and are often diagnosed incidentally upon imaging conducted for a variety of clinical complaints. They can be categorized as primary or secondary based on the presence or absence of an epithelial lining. Primary cysts are further subdivided into those that are and are not secondary to parasitic infection. The treatment of non-parasitic splenic cysts (NPSC) has historically been dictated by two primary factors: the presence of symptoms attributable to the cyst and cyst size greater or less than 5 cm. While it is appropriate to resect a symptomatic lesion, the premise of recommending operative intervention based on size is not firmly supported by the literature.

Methods

In the current study, we identified 115 patients with splenic cysts and retrospectively reviewed their management that included aspiration, resection, or observation.

Results

Our data reveal a negative overall growth rate of asymptomatic cysts, a high recurrence rate after percutaneous drainage, as well as demonstrate the safety of observing asymptomatic lesions over time.

Conclusion

We conclude that observation of asymptomatic splenic cysts is safe regardless of size and that aspiration should be reserved for those who are not surgical candidates or in cases of diagnostic uncertainty.

Keywords

Spleen Splenic cyst Cyst size Cyst management Surgery 

References

  1. 1.
    Hansen MB, Moller AC: Splenic cysts. Surg Laparosc Endosc Percutan Tech 2004, 14:316–22.PubMedCrossRefGoogle Scholar
  2. 2.
    Giovagnoni A, Giorgi C, Goteri G: Tumours of the spleen. Cancer Imaging 2005, 5 (October 2004):73–7.Google Scholar
  3. 3.
    Liu KK, Lee KH, Ku KW, Yeung CK: Decapsulation of symptomatic splenic pseudocyst–a further use for laparoscopic surgery in children. Eur J Surg 1996, 162:921–3.PubMedGoogle Scholar
  4. 4.
    Morgenstern L: Nonparasitic splenic cysts: pathogenesis, classification, and treatment. J Am Coll Surg 2002, 194:306–14.PubMedCrossRefGoogle Scholar
  5. 5.
    Vajda P, Kereskai L, Czauderna P, Schaarschmidt K, Kalman A, Koltai J, Engelis A, Kalman E, Lewicki K, Verebely T, Jainsch M, Petersons A, Pinter AB: Re-evaluation of histological findings of nonparasitic splenic cysts. Eur J Gastroenterol Hepatol 2012, 24:316–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Karfis EA, Roustanis E, Tsimoyiannis EC: Surgical management of nonparasitic splenic cysts. JSLS 2009, 13:207–12.PubMedCentralPubMedGoogle Scholar
  7. 7.
    Chin EH, Shapiro R, Hazzan D, Katz LB, Salky B: A ten-year experience with laparoscopic treatment of splenic cysts. JSLS 2007, 11:20–3.PubMedCentralPubMedGoogle Scholar
  8. 8.
    Inokuma T, Minami S, Suga K, Kusano Y, Chiba K, Furukawa M: Spontaneously ruptured giant splenic cyst with elevated serum levels of CA 19–9, CA 125 and carcinoembryonic antigen. Case Rep Gastroenterol 2010, 4:191–197.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Kaiwa Y, Kurokawa Y, Namiki K, Matsumoto H, Satomi S: Laparoscopic partial splenectomies for true splenic cysts. A report of two cases. Surg Endosc 2000, 14:865.PubMedCrossRefGoogle Scholar
  10. 10.
    Cowles RA, Yahanda AM: Epidermoid cyst of the spleen. Am J Surg 2000, 180:227.PubMedCrossRefGoogle Scholar
  11. 11.
    Smith ST, Scott DJ, Burdick JS, Rege R V, Jones DB: Laparoscopic marsupialization and hemisplenectomy for splenic cysts. J Laparoendosc Adv Surg Tech A 2001, 11:243–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Boybeyi O, Karnak I, Tanyel FC, Ciftçi AO, Senocak ME (2010) The management of primary nonparasitic splenic cysts. Turk J Pediatr, 52:500–4.PubMedGoogle Scholar
  13. 13.
    Musy PA, Roche B, Belli D, Bugmann P, Nussle D, Le Coultre C: Splenic cysts in pediatric patients–a report on 8 cases and review of the literature. Eur J Pediatr Surg 1992, 2:137–40.PubMedCrossRefGoogle Scholar
  14. 14.
    Elit L, Aylward B: Splenic cyst carcinoma presenting in pregnancy. Am J Hematol 1989, 32:57–60.PubMedCrossRefGoogle Scholar
  15. 15.
    Hom BL: Rupture of a calcified, non-parasitic splenic cyst after indirect trauma. J Med 1986, 17:241–52.PubMedGoogle Scholar
  16. 16.
    Bravo JL, Mangalmurti CS, Kowalak M: Management of a ruptured posttraumatic splenic pseudocyst: case report. J Trauma 1998, 45:165–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Spencer NJ, Arthur RJ, Stringer MD: Ruptured splenic epidermoid cyst: case report and imaging appearances. Pediatr Radiol 1996, 26:871–3.PubMedCrossRefGoogle Scholar
  18. 18.
    Qureshi MA, Hafner CD: Clinical manifestations of splenic cysts: Study of 75 cases. Am Surg 1965, 31:605–8.PubMedGoogle Scholar
  19. 19.
    Pachter HL, Hofstetter SR, Elkowitz A, Harris L, Liang HG: Traumatic cysts of the spleen–the role of cystectomy and splenic preservation: experience with seven consecutive patients. J Trauma 1993, 35:430–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Saada J, Parant O, Kessler S, Aziza J, Sarramon MF: Prenatal diagnosis and outcome of congenital splenic cyst: report of two cases. Prenat Diagn 2006, 26:9–10.PubMedCrossRefGoogle Scholar
  21. 21.
    Chen IL, Tsai CC, Yang SN, Liu CA, Hsu TY, Huang HC: Spontaneous regression of congenital splenic cyst in a neonate. Clin Pediatr (Phila) 2007, 46:73–5.CrossRefGoogle Scholar
  22. 22.
    Stoidis CN, Spyropoulos BG, Misiakos EP, Fountzilas CK, Paraskeva PP, Fotiadis CI: Spontaneous regression of a true splenic cyst: a case report and review of the literature. Cases J 2009, 2:8730.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Raffaelli CP, Bruneton JN, Giudicelli T, Guilleux MH, Chabassière D, Balu-Maestro C, Rogopoulos A, Bittmann O: [Cysts of the spleen. Spontaneous involution checked by imaging]. J Radiol 1991, 72:389–92.PubMedGoogle Scholar
  24. 24.
    Chang W, Liou C, Kao H, Hsu C, Chen C, Yu C: Solitary lymphangioma of the spleen: dynamic MR findings with pathological correlation. Br J Radiol 2007, 80:e4–6.PubMedCrossRefGoogle Scholar
  25. 25.
    Kaza RK, Azar S, Al-Hawary MM, Francis IR: Primary and secondary neoplasms of the spleen. Cancer Imaging 2010, 10:173–82.PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    Sinha CK, Agrawal M: Nonparasitic splenic cysts in children: Current status. Surgeon 2011, 9:49–53.PubMedCrossRefGoogle Scholar
  27. 27.
    Cleary S, Zalinski S, Vauthey J: Management of cystic diseases of the liver. In Curr Surg Ther. 10th edition. Edited by Cameron J, Cameron A.; 2011:271–276.Google Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2014

Authors and Affiliations

  • Christopher D. Kenney
    • 1
  • Yumiko E. Hoeger
    • 1
  • Amy K. Yetasook
    • 1
  • John G. Linn
    • 1
  • Ervin W. Denham
    • 1
  • Joann Carbray
    • 1
  • Michael B. Ujiki
    • 1
    Email author
  1. 1.Department of SurgeryNorthShore University HealthSystemEvanstonUSA

Personalised recommendations