Splenic epithelial cyst mistaken with Hydatid cyst: A case report

• Published in: International journal of surgery case reports 2018-01, Vol.53, p.21-24
• Main Authors: A. Sleiman, Youssef, Bohlok, Ali, El-Khoury, Melody, Demetter, Pieter, Zalcman, Marc, El Nakadi, Issam
• Format: Article
• Language: English
• Subjects: Hydatid cyst; Spleen conserving surgery; Splenic epithelial cysts
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2018.10.011

•Cystic lesions of the spleen are rare pathology with epithelial cyst being the most common type.•The radiologic imaging may be commonly misleading and non-conclusive and the definitive diagnosis is made on histopathology.•Splenic epithelial cyst should be kept in the differential diagnosis of a splenic cyst along with hydatid disease.•Surgical treatment is indicated for symptomatic cysts or those larger than 5 cm. Introduction: Cystic lesions of the spleen are infrequent and usually diagnosed incidentally. These lesions are rare and their differential diagnosis is very wide. Splenic epithelial cysts are the most common type of primary splenic cyst (4%). Surgical treatment is indicated for cysts larger than 5 cm or symptomatic. Nowadays, spleen preserving surgery is the gold standard treatment considering the immunologic role of the spleen and the increased risk of post-splenectomy infections. Case presentation: A 17 year old girl presented to the outpatient clinic with moderate left upper quadrant abdominal pain of 2 weeks duration with loss of appetite and denied fever, chills, sweating and jaundice. Abdominal examination showed tender splenomegaly. The abdominal imaging (Ultrasound, CT SCAN, MRI) was suggestive of hydatid cyst of the spleen, for which she received Albendazole for 1 month and then operated by laparotomy with partial resection and un-roofing of the splenic cyst. The pathology report showed a splenic epithelial cyst (SEC). Conclusion: SEC is a rare pathology that could mimic splenic hydatid cyst. The clinical and radiological pictures may be commonly misleading and non-conclusive. Definitive diagnosis is made on histopathology. Spleen conserving surgery, when possible, is the preferred modality for treatment.