Laparoscopic Marsupialization Surgery for Large Epidermoid Cyst of Spleen in a Child

概要

論文の詳細を見る
Epidermoid cysts of the spleen are relatively rare. Usually occurring in children and young adults, they are most often asymptomatic, though large cysts can cause symptoms. A 9-year-old Japanese girl was found to have proteinuria and microscopic hematuria by routine school urine testing. She was incidentally found to have an abdominal mass. On abdominal magnetic resonance imaging, a cyst measuring 12.7 cm × 12.6 cm × 14.7 cm was found in her left upper abdomen. The cyst was too large for nonoperative treatment. Given the patient's age, concerns over the risk of septicemia after splenectomy led to laparoscopic marsupialization surgery. On pathology, the lumen of the cyst was found to be lined with stratified squamous epithelium. A small area of epithelium was positive for Alcian blue and HBME-1, indicating its mesothelial origin. Markers that were present in a high concentration, such as CA125 in the serum and cystic fluid, and CEA in the cystic fluid, stained positively in the epithelium. This supported the idea that these markers were produced by the lining epithelium. Six months since the operation, the cyst has gradually increased in size to 11.9 cm × 8 cm. However, since the cyst is asymptomatic, the patient is under outpatient-follow-up without further treatment.
長崎大学の論文