A Case of Multiple Splenic Cysts with Relapsing Hemorrhage on Chemotherapy

Hidetaka Yamanaka, Eizi Nishigaki, Akihiko Hori, Tomonori Sugiura, Tohru Kawai, Satoru Kawai, Kiyoshi Hiramatsu, Yoshimi Kitagawa, Hiroshi Kono and Yutaka Matsuura

Department of Surgery, Nagoya Ekisaikai Hospital

Advances in imaging studies have made easier diagnosis of splenic cysts. We report a case of multiple splenic cysts with relapsing hemorrhage related to chemotherapy using anticancer drugs against right lung cancer and pleuritis carcinomatosa. A 58-year-old man reported left upper back pain during chemotherapy with anticancer drugs against right lung cancer and pleuritis carcinomatosa. He was found to be anemic in laboratory tests. Abdominal ultrasonography and computed tomography (CT) showed multiple splenic cysts, 1 of which had caused hemorrhaged. No cysts showed neoplastic lesions. He improved temporary with conservative therapy but after 14 days, symptoms curred and abdominal CT showed hemorrhage of another cyst. He was diagnosed with relapsing multiple hemorrhagic cysts, necessitating surgery. The pancreas, omentum, abdominal wall, and left diaphragm had adhered tightly to the spleen by fibrous connective tissue, so we conducted splenectomy with partial resection of these organs. The resected specimen showed4cysts up to 5 cm in diameter. All were monolocular and contained old blood. Cyst walls consisted of fibrous connective tissue with no lining cells, resulting in a diagnosis of pseudocysts. All cysts showed some stage of bleeding.

Key words
splenic cyst, anticancer drug, pseudocyst

Reprint requests
Hidetaka Yamanaka Department of surgery, Nagoya Ekisaikai Hospital 4-66 Syonen-cho, Nakagawa-ku, Nagoya-shi, 454-8502 JAPAN

Accepted
October 31, 2001

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