Search

Radiographic, sonographic, and histologic findings in a case of a huge splenic cyst in a newborn are presented. The patient had the characteristic findings, particularly the visceral displacement, associated with splenic cysts in a series of 10 older children and adolescents. The occurrence in a newborn of a large splenic cyst histologically similar to those found in older children supports the hypothesis that they are developmental rather than traumatically acquired.

We have reported a case of epidermoid cyst of the spleen, an uncommon congenital anomaly that usually occurs as an asymptomatic abdominal mass. The diagnosis of splenic cyst may be established by ultrasonography. Uncomplicated cysts should be resected, while infected cysts should be drained and resected after resolution of the infection. Splenic salvage should be achieved when possible.

Cysts of the spleen are still a rare entity. The present report describes a case of splenic cyst combined with a review of the literature in which classification, clinical manifestations, diagnosis, treatment, and etiology are discussed.

Ultrasound is an effective modality for the study of splenic cysts because it is able to distinguish between cystic and solid lesions. Three cases of splenic cyst are presented in which definitive diagnosis was made with ultrasound B-scan.

A young woman presented with a large mass in the left upper quadrant of the abdomen at a routine post-natal examination before leaving hospital after the birth of her first child. A plain radiograph showed a large smooth soft tissue opacity. A liver and spleen scan showed a normal but vertically orientated liver and a massive rounded defect in a very large spleen. A combined barium meal and intravenous pyelogram showed that the stomach and liver were displaced to the right and the intestines and left kidney downwards. A combination of these methods of examination led to correct pre-operative diagnosis. Radiology showed the displaced organs, whilst the scintigram demonstrated that the mass lay within the spleen, but did not distinguish between a solid or cystic structure. This was readily carried out by ultrasound as cysts are trans-sonic and free from internal echoes, whereas reflections are obtained from within solid tumours. Measuring the diameter of the cyst allowed its volume of approximately...

Splenic cysts are uncommon, with fewer than 600 cases reported in the world literature. This report concerns a case of cystic lymphangioma of the spleen, consisting of a large splenic cyst with associated multiple, small, subcapsular cysts and lymphangiectasia. The cysts are lined by endothelium, and they conform to the characteristics of dilated lymphatic channels. Lymphangioma of the spleen is thought to arise from congenital obstruction of lymphatic flow, with subsequent dilatation of lymphatic channels. The diagnosis and treatment of splenic cysts are discussed and a new classification of splenic cysts is proposed.

A 14-year-old female had a large, nontender abdominal mass on a routine sports physical examination. Following evaluation by ultrasound and computed tomography scan there was an initial attempt at drainage. The mass was subsequently removed. The diagnosis was epidermoid cyst of the spleen. In this report, we discuss the epidemiology and management of a splenic cyst, a rarely encountered diagnosis in adolescents, and emphasize the life-saving potential of the abdominal examination in sports medicine.

Highlights • Traumatic hydatid cyst of the spleen is rare entity. • A patient who has a hydatid cyst of the spleen may present with trauma. • Abdominal trauma and pain high suspicion should be made., INTRODUCTION Hydatid cyst (HC) can be observed in all parts of the body, splenic involvement represents 5% of all cases. Many ruptured HC's cases of a primary organ have been reported in the literature. However, only several splenic HC rupture has reported. A patient with traumatic rupture of splenic hydatic cyst is presented. PRESENTATION OF CASE 37 year old female sustained traffic accident presented our emergency department. In her physical examination there was hemodynamic instability, peritoneal irritation sign. An ultrasonographic examination of her abdomen showed intraperitoneal free fluid, a splenic rupture. The patient urgently operated; a 11 × 9 × 5 cm ruptured HC in the spleen was treated by splenectomy. During surgery the intraabdominal spaces were washed with povidoniodine and saline. Postoperative course of the patient was uneventful. The spleen was an organ involved with hydatidosis in our patient. Pathologic examination of the specimen revealed a splenic hydatid cyst. The patient is symptom free for 18 months. DISCUSSION Several traumatic ruptured splenic HC case are encountered in the literature. The cases in the literature almost always are not case report but those are one or more than one case in a case series. This case, an extremely infrequent encountered is reporting. CONCLUSION Early discovery is important since it is possible to cure viable HCs without dissemination to other organs by conservative surgery. If our patient was examined by ultrasound in a routine check up then her hydatid cyst of spleen would be discovered, the treatment of it would be made so no peritoneal dissemination with cystic fluid will be occur.

This paper is a retrospective study of the management of 58 cases of blunt splenic injury in the paediatric age group. Fifty of these cases were managed at the Adelaide Children's Hospital during the period 1964–1980 and eight cases at the Flinders Medical Centre during the period 1976–1980. A policy of non-operative management of blunt splenic injury was introduced to the Adelaide Children's Hospital in 1964, a policy not fully adopted until 1975. By this time nuclear scanning techniques were readily available and enabled accurate diagnosis of splenic trauma. Follow-up scans provided more knowledge of the healing process. Between 1975 and 1980 a total of 42 proven cases of blunt splenic injury were treated non-operatively, including one case of total avulsion of the spleen. Splenectomy was performed on 16 cases, all prior to June 1975. There was no case of post-splenectomy sepsis. Post-operative obstruction due to small bowel adhesions was encountered in 25% of the splenectomy cases. Comparison of results shows that non-operative management is preferable in selected children when adequate monitoring facilities are available. If the clinical condition deteriorates, operative intervention is indicated; this occurred in two patients, both of whom underwent splenectomy. Of the 42 patients treated non-operatively, delayed haemorrhage occurred in only one. There was no evidence of a post-traumatic splenic cyst in any of the follow-up scans.

A 14-year-old girl with bulimia was found to have an apparent submucosal mass of the gastric cardia by upper gastrointestinal series and endoscopy. At laparotomy the mass was found to be a 5 cm in diameter subcapsular serous splenic cyst compressing the stomach but not attached to it. The clinical and diagnostic features of this unusual lesion are reviewed, with particular emphasis on the endoscopic findings.

Cystic lesions of the spleen are uncommon, about 600 cases being reported in the world literature. This report concerns three pediatric patients treated by partial splenectomy for benign cyst. In the world literature most of the cystic lesions of the spleen are treated by splenectomy and more recently by partial splenectomy. The infected lesions are treated by splenectomy or by incision and drainage only. Partial splenectomy has evident advantage over splenectomy. Although in the world literature we have not found a single case of infected splenic benign cyst treated by partial splenectomy, we believe that this procedure also has an advantage over drainage as the infected and necrotic part of the cyst is removed, thereby reducing morbidity and further possible complications.

Infrared-contact coagulation of the spleen with an infrared-sapphire-coagulator was applied in two children with subcapsular hematoma and splenic cyst, thereby achieving complete and partial organ preservation, respectively. This method was also used for haemostasis following the dissection of a common liver in Siamese twins. Infrared-contact coagulation is a proper method for organ preservation in injuries or other pathological conditions of parenchymatous organs.

We reviewed 52 cases of splenic cysts on file at the Armed Forces Institute of Pathology. There were 24 true (epidermoid) and 28 false (posttraumatic) cysts. The history and clinical presentations, including pain, splenomegaly, or mass, were similar in both groups. Radiologic manifestations included splenomegaly and the occasional identification of a distinct mass by conventional radiography even in the absence of calcification. The lesions produced a photopenic defect on nuclear scintigraphy and were avascular on angiography. Sonography and CT demonstrated a cystic lesion with occasional septations, wall trabeculation, and low-level internal echoes. Three false cysts demonstrated solid and cystic components on sonography and CT, corresponding to organizing hematoma within the cyst. Splenomegaly or a splenic mass of a predominantly cystic nature with no clinical evidence of echinococcus suggests the diagnosis of splenic cyst. Reliable radiologic distinction between true or false splenic cyst does not seem possible. Complex mass may represent a "transition" between hematoma and false splenic cyst.

There is international agreement which confirms the serious risks to splenectomized patients because of overwhelming postsplenectomy infections (OPSI) and other serious infections. By analysis of reports of individual cases (Appelbaum et al. 1979; Grinblat and Gilboa 1975; King and Shumacker 1952; Orlando and Moore 1972; Passl et al. 1976; Stogmann and Paky 1980; Tan 1982) and of collections of larger numbers (50–500) of patients (Belohradsky et al. 1982; Ein et al. 1977; Ellis and Smith 1966; Eraklis et al. 1967; Holschneider et al. 1982; Wahlby and Domellof 1981; Wahlby 1981; Wegelius 1982) and from a few publications, which collected figure of more than 500 patients (Eraklis and Filler 1972; Erickson et al. 1968; Koglmeier 1982; Walker 1976), it is recognized that there is an extremely high risk of fatal infection following splenectomy.

Ultrastructural findings in a feline ventral abdominal vascular tumour showed lack of basal lamina, few micropinocytotic vesicles and intercellular junctions and a discontinuous endothelial cell layer. A splenic cyst had a continuous basal lamina, numerous micropinocytotic vesicles and intercellular junctions and a continuous endothelial cell layer. These findings were compatible with diagnosis of lymphangiosarcoma (ventral abdomen and metastases) and haemangiosarcoma (splenic cyst).

The authors present three cases of atypical pancreatic pseudocysts, occurring in the course of chronic pancreatitis: intrasplenic pseudocyst, pseudocyst in the hilus of spleen and bleeding into the pseudocyst of the tail of pancreas. Such cysts are extremely difficult, or even impossible to be recognized by conventional clinical and radiological methods. Located in the parenchyma or in the hilus of spleen, they are formed by means of fistulization along the lienorenal ligament. In every case when the chronic pancreatitis coexists with the splenic cyst, the intrasplenic localization of the pancreatic speudocyst should be taken into consideration. The cyst in the hilus of spleen may imitate intraperitoneal mass and its relation with the pancreas may be recorded angiographically only. Angiography is also the basic diagnostic method in the haemorrhage into the pseudocyst. Bleeding into the pseudocyst has a form of vascular blush appearing during arteriography. The blush increases its intensity and persists after an examination. Early diagnosis in atypical pseudocyst is vital for the patient's fate.

Percutaneous aspiration and tetracycline sclerosis is a safe but temporary therapy of large splenic cysts in children. Between 1985 and 1987, three girls with splenic cysts were seen. Their ages ranged from 5 to 14 years, and the cysts were from 8 to 16 cm in diameter. Despite their large size, all were asymptomatic and were discovered upon physical examination or ultrasound for unrelated conditions. All cysts were avascular by scan and had irregular crenated or smooth walls by ultrasound. Further investigation excluded infectious or parasitic causes. Each cyst was aspirated for diagnosis, and a pigtail catheter was inserted for drainage and sclerotherapy. All needle aspirations resulted in cyst collapse, but in one patient the pigtail catheter insertion was unsuccessful, and in the other two cases, multiple attempts of tetracycline sclerosis failed to obliterate the cysts. There were no other complications. Surgery for the recurrent splenic cysts was performed 3 months to 2 years following the percutaneous procedures. The two patients operated on with 3 months of aspiration underwent successful partial splenectomy and have normal splenic function by ultrasound scan, and absence of RBCs. The third patient had progression of the cystic disease throughout the spleen, and required splenectomy. Pathology confirmed multiseptate congenital mesothelial cysts in the first two patients and massive lymphangiomatosis in the third. In all three cases, percutaneous therapy was safe but did not result in long-term control. In one patient, the cystic disease progressed following sclerotherapy and may have influenced the need for complete splenectomy. Prior manipulation did not adversely affect the dissection and mobilization of the spleens. Based on this experience, we recommend that partial splenectomy is the procedure of choice for permanent control of congenital splenic cysts until more effective percutaneous methods are available.

Among all abdominal masses in newborns, more than half are of nonsurgical nature, and of those which are surgical, more than half originate in the urinary tract.

The authors report two cases of traumatic rupture of splenic cyst. In each case a previous abdominal trauma was found responsible for the presence of the cyst. A new minor abdominal trauma provoked a major haemoperitoneum. In both cases laparotomy revealed the rupture of a large cyst of the upper pole of the spleen, with extension of the lesion into healthy splenic parenchyma. Conservative splenic surgery with cystectomy was possible in both cases; microscopic examination confirmed a true pseudocyst in case 2. In presence of haemoperitoneum and ultrasonographic view of a splenic cyst, the treatment should be surgical in contrast to the more conservative attitude now recommended for the usual splenic trauma.

A review of the history of cysts of the spleen, including an illustrative case report of a traumatic splenic cyst, is presented. The importance of palpation of the spleen upon routine physical examination is emphasized.

NONPARASITIC cysts of the spleen can be divided into two categories, capsular and parenchymatous cysts, depending on the relationship of the cysts to the splenic capsule. The parenchymatous category includes epidermoids, cystic angiomas, and large unilocular fibrous-walled cysts of uncertain origin (this type of cyst is also referred to as a false cyst, with the implication that it is secondary to trauma or hemorrhage). The term "true cysts" refers to cysts with a specific type of lining cell other than fibroblasts. Cysts of the spleen are unusual; Ferris and associates1reported that only 19 cystic spleens were removed surgically at the Mayo Clinic over a period of 46 years and only one of the 19 surgical specimens exhibited a line of squamous, keratinizing epithelium. Tamaki2was unable to find a single case of splenic cyst in the surgical file of the Jefferson Medical College Hospital for the years

Masses in the upper left quadrant of the abdomen present an interesting problem in differential diagnosis. To be considered also are tumors of the stomach, pancreas, colon, and kidney. Retroperitoneal lymphomas, teratomas, and sarcomas may present as a mass in this area. Pseudocysts of the pancreas may also occur in this area. Cysts of the spleen are rare. Andral (cited by Fowler2) recorded the first splenic cyst in 1829. Since then over 200 cases have been reported. Of these, 40 have been calcified.1To give an idea of the rarity of this disease, Pemberton3in 1940 reviewed 800 splenectomies done at Mayo Clinic and found only a 5% incidence. At Ohio State University, 934 splenectomies have been performed since 1940. Only two cysts have been reported. Both were pseudocysts, and one was calcified. The calcified cyst was the subject of the present article. Fowler2in a collective

Cases of splenic cyst and pancreatic tumour are reported. On both occasions pre-operative arteriography proved to be of major practical value.

Cysts of the spleen are rare, and their preoperative diagnosis even rarer. The following case report is therefore thought to be worthy of record. The patient, a lady of 28, presented with a swelling in the left upper abdomen, which she had first noticed two years previously, and which was gradually increasing in size. She gave a history of a bullet wound (sustained during a hold-up in Baker Street) in March, 1947. At that time, a ruptured spleen was suspected clinically, and an emergency laparotomy was performed. However, no intra-abdominal abnormality was found, the spleen was palpated and found to be normal and the abdomen was closed. The bullet was not found. A left haemothorax was aspirated, and the patient made a good recovery. In January, 1948, she had a small haemoptysis, and a chest radiograph then showed the bullet lying in relation to the left dome of the diaphragm. At thoracotomy in March, 1948, this was found to be lying enclosed in fibrous tissue on the upper surface of the diaphragm and was ...

True spleen cysts are uncommon and rarely associated with elevated serum and intracystic tumor markers CA 19-9 and CEA levels. A 19-year-old woman with a left subcostal mass was observed. Echinococcus granulosus serology was negative, and serum tumor markers CA 19-9 and CEA levels were 273 kU/L and 33 ng/mL, respectively. CT-scanning showed a splenic cyst of 18 cm in greatest diameter. The patient underwent total laparoscopic splenectomy and the serum tumor markers progressively decreased and became normal three months after surgery. Splenic cysts derive from an invagination of the splenic capsule in the splenic pulp with a subsequent squamous metaplasia. This last evidence could be confirmed from the variable cellular differentiation lines of the mesothelial squamous cells in the cyst wall. We should not exclude a higher degenerative potential of cystic epithelium that produces de-differentiation proteins. The lowering of the serum levels of the two markers after the cyst removal is witness of the direct relationship between the increment of the serum tumor markers and the presence of the epidermoid cyst.

Introduction Desmoid tumor is a rare, benign, usually asymptomatic fibromatous lesion. The etiology is unknown and the diagnosis is based on histopathological examination. The treatment is complete resection of the tumor. Pancreatic desmoid tumor is extremely rare. In the literature there have been only 11 cases described, most of them as solid or solid-cystic masses. We report the case of a patient with an isolated cystic pancreatic desmoid tumor that is, to the best of our knowledge, the second reported case. Case presentation A 13-year old Caucasian boy presented with recurrent pain of two months’ duration in the left hypochondrium of his abdomen. An ultrasound examination and computed tomography scan revealed the presence of a cystic mass located in his splenic hilum, tightly adjacent to the pancreatic tail. A splenic cyst was suspected. Operative findings showed a 10x10cm cystic mass tightly connected to the pancreatic tail and left colonic flexure, adherent to the spleen, splenic vein and artery. Distal splenopancreatectomy with en bloc resection of the left colonic flexure was performed. Histological analysis confirmed that the resection was complete. The mass had infiltrated the pancreatic parenchyma. All tumor cells were positive for anti-beta-catenin staining characteristic for desmoid tumor. No abnormalities in the spleen and colon were found. Conclusions Isolated sporadic pancreatic desmoid tumor with cyst formation is extremely rare and its diagnosis can be difficult, especially because of uncharacteristic symptoms and radiological findings, as in our patient. This case report should be of interest not only to surgeons, as the treatment of choice is radical resection, but also gastroenterologists, considering it is in close relation with familial adenomatous polyposis, and oncologists as the reason for differentiation with other pancreatic tumors.

The authors describe a case of nonparasitic splenic cyst treated by laparoscopic fenestration. The patient complained of left upper quadrant pain that increased during the prior 3 months. Computed tomography scan revealed a large cyst of the inferior pole of the spleen. The patient was submitted to laparoscopic wide fenestration of the cystic wall. The postoperative course was unremarkable and the patient was discharged with complete relief of symptoms. Laparoscopic technique provides the same results in terms of effectiveness and safety as traditional surgery, linked to the benefits of the mininvasive approach; thus, the laparoscopic fenestration can be considered the ideal treatment of nonparasitic splenic cysts.

Radioactive liver imaging is a useful investigation for localizing space occupying lesions in the liver (McAfee, Ause and Wagner, 1965). The liver is pliable and compression by adjacent organs can produce false positive filling defects in the radioactive hepatic image. We report a case of such a false positive filling defect which was caused by a large solitary splenic cyst. Such an appearance has not been previously recorded.

The spleen is the least common intra-abdominal site for the development of cystic disease. A lymphangioma of the spleen was first reported in 1885 by Fink; since that time 47 cases of lymphangioma or lymphangectasia have been reported. Up to now, no CT study has been published. This report concerns a case of cystic lymphangioma of the spleen consisting of a large splenic cyst with associated multiple small subcapsular cysts and lymphangectasia. The utility of CT in diagnosis is presented.

A congenital splenic cysts in a 5.5 year old girl was aspirated under ultrasonographic guidance and injected with 150 mg Tetracycline (intended for IV use). Septation and gradual resorption of the cyst occurred during the following weeks, leaving small residual cysts which have remained stable for the last 12 months. Splenectomy and its possible complications were avoided.

A case is described of a splenic cyst in a child aged 11 years where diagnosis was made pre-operatively by means of splenography.

The authors present a rare case of pathology from spleen, a nonparasitic, non-neoplastic splenic cyst, in an adult male patient without a previous history of abdominal trauma. Principal clinical findings were pain in left upper quadrant, nausea, regurgitation and precocious satiation. On investigation, ultrasonography and CT scan showed an expansive lesion in the spleen, compressing the stomach. Surgical procedure was splenectomy and a microscopical examination revealed a non- parasitic, non-neoplastic splenic cyst. Splenic cysts are usually benigns, but surgical remotion is necessary when they are symptomatic or exist risk of rupture. In this report is presented the classification of splenic cysts, clinical manifestations, diagnostics methods and discussed their surgical treatment.

To the Editor .—Following is a description of a true case of hypersplenism. Report of a Case .—A 20-year-old woman presented with a painful mass in the left upper quadrant of the abdomen. Ultrasonography disclosed an enlarged spleen. Over the following year the mass enlarged dramatically. The patient denied any history of trauma, mononucleosis, hepatitis, fever, chills, or night sweats. Significant aspects of the physical examination included an absence of hepatomegaly and lymphadenopathy. Abdominal examination demonstrated a hard, nontender, fixed, protuberant mass in the left upper abdominal quadrant that extended laterally to the right midclavicular line and inferiorly beyond the umbilicus. Laboratory values were as follows: hemoglobin level, 10.9 g/dL (109 g/L); hematocrit, 35.9% (0.36); white blood cell count, 3.6×10 3 /mm 3 (3.6×10 9 /L); and platelet count, 134 000/mm 3 (134 × 10 9 /L). An abdominal computed tomographic (CT) scan disclosed a greatly enlarged spleen with a

now screening a rural community identified as at high risk, with a surgical incidence rate for hydatid cyst of 200 per 100 000 inhabitants (mean for central Tunisia 22 per 100 0002). In this community, 1179 subjects over the age of 5 years (83-8% of the population in this age range) were examined by echotomography with a portable apparatus.1 41 hepatic cysts and 1 splenic cyst (prevalence 3-6%) were diagnosed. In the study population 17 subjects (including 1 with a positive echotomogram) had previously been operated on for abdominal hydatid cyst (cumulative prevalence rate 4-9%. Given the agreement between ELISA findings and echotomographyl,3 and the fact that echotomography is more feasible than ELISA, we agree with Macpherson et al that echotomography be used alone for assessing the prevalence of hydatid cyst. Our two surveys in neighbouring communities in central Tunisia have yielded very different prevalence rates and have uncovered a focus of unexpectedly high endemicity. In such an

Traumatic splenic cyst is one of many diagnostic choices when a mass is found in the left upper quadrant. In the appropriate clinical setting, demonstration of an intrasplenic, unilocular, avascular, homogeneous, fluid-filled mass with a smooth, sharply marginated wall should suggest a splenic cyst. On pathological examination, an epithelial lining implies a developmental origin. More commonly, no such lining is found and old trauma is assumed to be the etiology.

A perusal of the medical literature reveals that cysts of the spleen are uncommon. Only 4 cases in approximately 800 splenectomies were reported by Pemberton at the Mayo Clinic during a 30-year period. 13 A total of 265 nonparasitic splenic cysts were collected from the world literature by Fowler in 1953 in an extensive review of the subject. 5 Cysts which contain an internal cell lining have been termed "true cysts." The types of lining include epidermoid, dermoid, endothelial, and cuboidal, several cases of hemangioma and lymphangioma also being reported. The present article will detail what the authors believe to be the first reported case of congenital splenic cyst lined by secretory transitional epithelium, possibly arising from inclusion of mesonephric structures into the developing splenic anlage at about the fifth to eighth week of embryonic life. Report of Case A 13-year-old Caucasian girl was transferred to the University of California

Splenic cysts are bizarre entities which are of interest not only for their rarity but also for the mystery which surrounds their pathogenesis. In 800 splenectomies done at the Mayo Clinic, Pemberton1afound but 4 cases of splenic cyst (0.5%). Since the first report of cystic disease of the spleen by Andral2in 1829, less than 200 splenic cysts have been mentioned in the literature, of which about 40 have been calcified. The occurrence of a large solitary calcified cyst of the spleen is considered worthy of mention and represents the basis of this report. Classification Fowler3classified splenic cysts as dermoid, parasitic, and nonparasitic varieties. Dermoid cysts of the spleen resemble dermoids elsewhere and are extremely rare; parasitic cysts arise from involvement of the spleen by Echinococcus disease. Other cysts fall into the nonparasitic varieties and are divided into true cysts and pseudocysts, depending upon the

Cysts of the spleen as a pathological entity were first recorded by Andral in 1829. The sparse, relevant literature since then attests to the fact that they are unusual, and a review of the literature by Bell, in 1951, revealed that a total of only 188 had been recorded. The purpose of this report is to review briefly the pertinent literature and to present a case of post-traumatic splenic cyst, one of unusual size and presenting many problems in differential diagnosis. Cystic tumors of the spleen may be classified as follows: True cysts—lined by specific secreting membrane Epithelial 1. Dermoid 2. Epidermoid Endothelial 1. Lymphangioma 2. Hemangioma 3. Polycystic disease 4. Some serous cysts Parasitic—lined by protoplasmic matrix containing numerous nuclei 1. Hydatid cyst caused by Echinococcus False cysts—no specific secreting lining A. Hemorrhagic B. Serous C. Inflammatory 1. Acute necrosis in infection 2. Chronic tuberculosis D. Degenerative liquefaction of

Nonparasitic solitary splenic cystic lesions occurred in four patients. Selective arteriography was successful in each instance in determining the correct preoperative diagnosis of splenic cyst. Subsequent histologic examination classified two lesions as false cysts, one as a true cyst, and one as a chronic cystic hematoma (or false cyst). There appeared to be no difference in the arteriographic pattern between true and false splenic cysts, or between these cysts and chronic splenic hematomas. The presence of active infection within the splenic cyst was suspected in one patient from the arteriographic demonstration of a thickened cyst wall.

Splenic cysts are rare clinical findings, detected due to derivative symptoms or as a random discovery in abdominal imaging. Although there still remains controversy as to their optimal treatment, bigger secondary cysts should be treated surgically. However, spontaneous regression may be observed in cysts with a diameter smaller than 4 cm. In these cases, expectant treatment is preferable. We report, herein, a single case of a splenic cyst in an adult woman, who reported minor symptoms despite the size of the lesion and who demonstrated a possible almost total regression of the cyst within a ten-year period, accompanying with review of the most recent literature.

We present a case of multiple hydatidosis in an 8-year-old boy that resulted from a ruptured hydatid cyst of the spleen and spread into the peritoneal cavity. We also present a new approach for managing these difficult and high-risk cases.