-Case Reports-

Giant Epidermoid Cyst of the Spleen with Elevated CA 19-9 Production Managed Laparoscopically: Report of a Case

Arichika Hoshino¹, Yoshiharu Nakamura², Hideyuki Suzuki¹, Satoshi Mizutani¹, Naoto Chihara¹, Tetsuro Matsunobu¹, Kentaro Maejima¹, Katsuhiro Miura¹, Hidetsugu Hanawa¹, Satoshi Nomura¹, Tetsutaka Toyoda¹, Seiji Yamagishi¹, Ryosuke Nakata¹, Akira Muraki¹ and Eiji Uchida²

¹Institute of Gastroenterology, Nippon Medical School Musashi Kosugi Hospital
²Department of Gastrointestinal Surgery, Nippon Medical School

True splenic cysts are uncommon and are associated with elevated serum and intracystic tumor marker CA 19-9 levels. A 33-year-old woman presented to our hospital with a chief complaint of epigastralgia. Computed tomography of the abdomen showed a 10-cm cystic lesion in the spleen. The serum carbohydrate antigen (CA) 19-9 level was 3,347 U/mL (normal, <37 U/mL). Total laparoscopic splenectomy was performed, and the serum level of CA 19-9 had normalized 2 weeks later. Pathological examination showed a benign true epidermal cyst of the spleen with strong immunohistological staining for CA 19-9. Splenic epidermoid cysts most often occur in young women, and laparoscopic surgery to remove cysts of this type is minimally invasive. Thus, laparoscopic surgery should be the method of first choice for most cases of splenic benign true cyst.

J Nippon Med Sch 2013; 80: 470-474

Keywords
laparoscopic splenectomy, splenic epidermoid cyst, carbohydrate antigen 19-9

Correspondence to
Arichika Hoshino, Institute of Gastroenterology, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
kuma-3@momo.so-net.ne.jp

Received, July 24, 2013
Accepted, August 26, 2013