Epidermal Cyst of the Spleen Associated with Elevated Serum and Intracystic CA19-9 Levels -A Rare Case Report-

Katsuo Shimada, Seiichi Kiriyama, Yoshiro Yamashita, Shigetoshi Tsuzuki¹⁾, Shuichirou Kitahara¹⁾, Hayashi Inaba²⁾, Yoshiaki Karaki, Kenji Tazawa, Masao Fujimaki¹⁾

Second Department of Surgery, Toyama Medical and Pharmaceutical University
¹⁾First Department of Surgery, Shinshu University
²⁾Department of Pathology, Shinshu University

A 9-year-old child was admitted to our hospital for left upper abdominal fullness. Ultrasonography and computerized tomography revealed a large cystic tumor in the hilus of the spleen. Sonographically a preoperative guided aspiration biopsy of the tumor was performed. Cytological examination revealed contaiminating squamous epithelial cells. Splenectomy was performed under the diagnosis of a splenic epidermoid cyst. The inner surface of the cyst was lined by squamous epithelium and reacted positively to CA19-9 and CEA immunohistochemical staining. Laboratory studies showed moderately elevated serum CA19-9 level (860 u/ml) preoperatively but its level had decreased to the normal range one month after splenectomy. Splenic epidermal cyst associated with a moderately elevated CA19-9 level is rare, and to our knowledge this is the third case of its kind reported in the literature. Our findings suggest that measurement of CA19-9 in the serum and cystic fluid may be useful as a supplementary diagnostic procedure in this disease on a case by case basis.

Key words
epidermal cyst of the spleen, CA19-9, splenectomy

Reprint requests
Katsuo Shimada The Second Department of Surgery, Toyama Medical and Pharmaceutical University
2630 Sugitani, Toyama, 930 JAPAN

Accepted
November 11, 1992

To read the PDF file you will need Abobe Reader installed on your computer.