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Background: Splenic cysts are uncommon and very rarely malignant therefore their treatment isn't standardized. In case of symptomatic cysts different surgical approaches have been suggested. Primary malignant lymphoma of the spleen comprises less than 1% of non-Hodgkin's lymphomas. To our knowledge, only 203 cases of splenic large B-cell lymphoma (LBCL) have been reported to date and only 2 of them were fibrin-associated splenic cysts. Case presentation: 27-year-old model with a 19 × 13 cm splenic cyst without data of malignancy in the preliminary study and therefore treated with laparoscopic deroofing. After histological diagnosis of LBCL with a fibrin/EBV-associated splenic pseudocyst, the patient received 4 cycles of Rituximab and a laparoscopic splenectomy was performed due to resurgence of the pseudocyst. No evidence of malignancy has been found during follow up (EBV viral load every 3 months during the first year, PET-CT every 6 months during the first year and annual afterwards) performed after the splenectomy. Discussion and conclusions: The value of tumor markers and radiology for diagnosis of splenic cysts is put into question. Only 60 cases of Fibrin-associated LBCL (FA-LBCL) have been described in the literature therefore there are no treatment guidelines for them even though surgery together with systemic treatment has been the prevalent route with good results in most cases. [ABSTRACT FROM AUTHOR]

Abstract Background Splenic cysts are uncommon and very rarely malignant therefore their treatment isn’t standardized. In case of symptomatic cysts different surgical approaches have been suggested. Primary malignant lymphoma of the spleen comprises less than 1% of non-Hodgkin’s lymphomas. To our knowledge, only 203 cases of splenic large B-cell lymphoma (LBCL) have been reported to date and only 2 of them were fibrin-associated splenic cysts. Case presentation 27-year-old model with a 19 × 13 cm splenic cyst without data of malignancy in the preliminary study and therefore treated with laparoscopic deroofing. After histological diagnosis of LBCL with a fibrin/EBV-associated splenic pseudocyst, the patient received 4 cycles of Rituximab and a laparoscopic splenectomy was performed due to resurgence of the pseudocyst. No evidence of malignancy has been found during follow up (EBV viral load every 3 months during the first year, PET-CT every 6 months during the first year and annual afterwards) performed after the splenectomy. Discussion and conclusions The value of tumor markers and radiology for diagnosis of splenic cysts is put into question. Only 60 cases of Fibrin-associated LBCL (FA-LBCL) have been described in the literature therefore there are no treatment guidelines for them even though surgery together with systemic treatment has been the prevalent route with good results in most cases.

Wandering spleen is extremely uncommon, with a reported incidence of

Laparoscopic fenestration is the preferred treatment for symptomatic splenic cysts because it is curative and spleen‐sparing. We report a case of a 25‐year‐old female who underwent laparoscopic fenestration for a giant splenic cyst using a single‐incision plus one‐port approach. She presented to our hospital with repeated vomiting. Imaging showed a 23 × 18 cm splenic cyst with no solid components, strongly compressing the stomach to the right side. Laparoscopic fenestration was initiated through a 2.5‐cm umbilical incision, and a 5‐mm port was added in the left abdomen intraoperatively. The drain placement was deemed necessary to prevent abscess formation and post‐operative bleeding because of a thick cyst component and unexpectedly thick wall. Splenic cysts are typically benign and commonly develop in young people, hence, organ preservation and cosmetic results are crucial. Laparoscopic fenestration using single‐incision plus one‐port is considered to be an appropriate procedure for giant splenic cysts with non‐serous contents. [ABSTRACT FROM AUTHOR]

Wandering spleen is extremely uncommon, with a reported incidence of <0.5%. A cyst within the spleen is also uncommon. The majority of primary splenic cysts fall into the epithelial cyst category. The affected patients present with atypical symptoms, like feeling fullness in the left upper abdomen and a palpable mass. The treatment of a large wandering splenic cyst is an open splenectomy. This case presents a unique combination of a wandering spleen with a huge ruptured cyst, featuring an unusual right lower abdominal and pelvic location, a twisted pedicle, and a remnant of normal splenic parenchyma, collectively constituting an exceedingly rare clinical scenario. [ABSTRACT FROM AUTHOR]

BackgroundSplenic cysts are relatively rare benign tumors that are asymptomatic in most patients and are usually discovered incidentally by imaging. In our case, we report a splenic cyst in a child who underwent laparoscopic partial splenectomy.Case descriptionA 13-year-old boy was admitted to the hospital after an incidental finding of a splenic cyst on an abdominal ultrasound conducted 4 days prior. He was asymptomatic before admission. Upon admission, abdominal ultrasound and CT revealed a cystic lesion in the spleen, highly suspicious for a splenic cyst. Then, we used transumbilical single-site laparoscopic exploration and found a cyst measuring approximately 12 cm × 11 cm × 10 cm at the upper pole of the spleen, so we performed a partial splenectomy and diagnosed a primary epithelioid splenic cyst via postoperative pathology.ConclusionsSplenic cysts in children are very rare and can be treated conservatively in asymptomatic patients with a diameter of less than 5 cm, while surgery is required in symptomatic patients or those with a diameter greater than or equal to 5 cm. Transumbilical single-site laparoscopic partial splenectomy is a minimally invasive and effective treatment, especially for children.

Splenic hydatid cysts are caused by the Echinococcus species and rarely occur in pregnancy. This case report describes the management of a 29-year-old pregnant woman with a large (11 × 8.7 × 10.5 cm) splenic hydatid cyst. The cyst had been identified before she became pregnant by her general practitioner with imaging investigations undertaken for her persistent left upper abdominal pain. The patient also had laboratory investigations which were positive for echinococcosis species.Hydatid splenic cysts are very rare and even more so in pregnancy. Risk of splenic cyst rupture exists, and rupture has significant risk of maternal and perinatal morbidity and mortality. Among the few case reports in the literature there is no clear consensus on conservative or surgical management during pregnancy and no clear guidelines for intrapartum care or delivery. The case report reviews the literature on splenic hydatid cyst disease in pregnancy and explores the management and outcome of this patient through her fourth pregnancy, which resulted in an uncomplicated vaginal birth.

Isolated splenic lymphangiomas are rare benign lesions mostly seen in children are exceptionally rare in adults, often discovered incidentally due to their typically asymptomatic nature. This case report elaborates on the surgical excision of a rare splenic cystic lymphangioma in a 33-year-old woman, underscoring the diagnostic and therapeutic challenges these tumors pose. The patient's symptoms, abdominal pain and a palpable mass led to imaging through ultrasound and CT, which revealed a cystic splenic lesion. Total splenectomy was performed, revealing a large cystic mass, with pathological examination confirming a cystic lymphangioma. This case emphasizes the necessity of considering splenic lymphangiomas in adult patients presenting with splenic lesions. It also highlights the critical role of surgical interventions for definitive diagnosis and to prevent complications such as rupture and hemorrhage, thereby emphasizing on the complexity of managing rare splenic tumors. [ABSTRACT FROM AUTHOR]

Background: Splenic cysts are relatively rare benign tumors that are asymptomatic in most patients and are usually discovered incidentally by imaging. In our case, we report a splenic cyst in a child who underwent laparoscopic partial splenectomy., Case Description: A 13-year-old boy was admitted to the hospital after an incidental finding of a splenic cyst on an abdominal ultrasound conducted 4 days prior. He was asymptomatic before admission. Upon admission, abdominal ultrasound and CT revealed a cystic lesion in the spleen, highly suspicious for a splenic cyst. Then, we used transumbilical single-site laparoscopic exploration and found a cyst measuring approximately 12 cm × 11 cm × 10 cm at the upper pole of the spleen, so we performed a partial splenectomy and diagnosed a primary epithelioid splenic cyst via postoperative pathology., Conclusions: Splenic cysts in children are very rare and can be treated conservatively in asymptomatic patients with a diameter of less than 5 cm, while surgery is required in symptomatic patients or those with a diameter greater than or equal to 5 cm. Transumbilical single-site laparoscopic partial splenectomy is a minimally invasive and effective treatment, especially for children., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Kong, Chen, Bai, Yan, Yi, Wang, Liu, Jia, Liu and Zhang.)

An 89-year-old female presented to the emergency department (ED) with hypotension and altered mental status. The patient had no external signs of trauma or hemorrhage and no abdominal tenderness on examination. The patient remained hypotensive after initial fluid resuscitation, and laboratory testing revealed a significant anemia. Point-of-care ultrasound (POCUS) was used to perform a rapid ultrasound in shock (RUSH) exam in an attempt to uncover the etiology of undifferentiated hypotension. The exam displayed free fluid in the right upper quadrant and the left upper quadrant exam demonstrated a large splenic lesion with mixed echogenicity. Subsequent computed tomography (CT) of the abdomen and pelvis with intravenous contrast suggested a ruptured hemorrhagic splenic cyst, and the patient underwent an emergent splenectomy for hemorrhage control. Operative pathologic examination revealed the cystic lesion to be a splenic hemangioma. This case report highlights the utility of the Rapid Ultrasound for Shock and Hypotension (RUSH) protocol when evaluating patients with undifferentiated nontraumatic shock, and a rare cause of spontaneous intra-abdominal hemorrhage., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities., (Copyright © 2024, Glusman et al.)

Splenic cysts are extremely rare entities that typically result from prior abdominal trauma, infections, and degenerative diseases. They are divided into two categories: true cysts with epithelial lining, and false pseudocysts without epithelial lining, which is more common than true cysts. We describe here a case of a non-traumatic splenic pseudocyst in a healthy 29-year-old male patient, who presented with left upper quadrant abdominal pain. Physical examination revealed scaphoid abdomen and left hypochondrium fullness. The spleen was uniformly enlarged, smooth, and firm, with mild tenderness. Laboratory testing was normal. An abdominal CT scan showed a huge unilocular non-enhancing cyst occupying the upper part of the spleen, measuring around 16 × 18.5 × 20 cm. The patient was managed with cyst aspiration and partial cystectomy. The histopathological examination findings are consistent with splenic pseudocyst. A one-year follow-up period revealed no complications or recurrence. Spleen cysts are rare in clinical practice, posing challenges in diagnosis and treatment. Surgical options include partial or total splenectomy, cyst aspiration, percutaneous drainage, partial cystectomy, and marsupialization. The choice depends on the cyst's size, splenic coverage, and relation to the hilum. Recently, spleen-preserving approaches have been favored to avoid life-threatening sepsis. Non-traumatic splenic pseudocysts present significant diagnostic dilemmas, requiring histopathological examination for definitive diagnosis. Spleen-preserving management is highly recommended to reduce the risk of life-threatening sepsis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Abu Sabha et al.)

Primary (isolated) splenic hydatid cyst is rare and accounts for less than 2 % of hydatid patients, even in endemic regions. Diagnosis of splenic hydatid cyst can be challenging due to the rarity of the condition and its nonspecific symptoms. Surgery is the mainstay of treatment. This case report discusses management options for such a rare condition. We present a 33-year-old female patient with abdominal pain for six months and splenomegaly. Ultrasonography and CT scan showed a giant splenic cyst with clear walls and multi-vesicular contents suggestive of a hydatid cyst. There was no involvement of the liver or other organs. Indirect hemagglutination was positive for Echinococcus. Through a left subcostal incision total splenectomy was performed. The patient was discharged from hospital on the sixth postoperative day. No local recurrence was detected during postoperative follow up. Primary splenic hydatid disease is rare. It may be detected incidentally or present with nonspecific complaints. If untreated, a splenic hydatid cyst can lead to various potentially severe complications, including cyst rupture and secondary infection. Standard treatment is open total or partial splenectomy: preservation surgery should always be considered, to avoid post splenectomy infection, especially in young patients. Primary splenic hydatid cyst is rare even in endemic areas. Symptoms may be non-specific. Standard treatment is open total or partial splenectomy. • The spleen is the third most common site of hydatid disease, after the liver and lungs • Splenic hydatid cyst can be either primary (isolated to the spleen only) or secondary (accompanied by hydatid cysts in other organs) • Primary splenic hydatid cyst is rare even in endemic regions • Diagnosing hydatid cyst disease of the spleen can be challenging due to the rarity of the condition and often nonspecific symptoms • Surgery is the usual management of hydatid cyst of the spleen [ABSTRACT FROM AUTHOR]