Spontaneous Rupture of an Epidermoid Cyst of the Spleen

Kuniyasu Murahashi, Keiichi Takagaki, Keeko Kishimoto, Kouichi Nishino, Toyoaki Aoki, Michio Sowa and Shingo Ishiguro*

Department of Surgery, Osaka Ekisaikai Hospital
Pathology and Cytology Laboratories, PCL Osaka*

We report a rare case of spontaneous rupture of an epidermoid splenic cyst. A 21-year-old woman seen for acute lower abdominal pain onset had normal blood pressure, was not anemic and showed severe pain, tenderness, rebound tenderness, and muscle guarding in the lower abdomen. No abnormal mass was palpable. Abdominal computed tomography (CT) showed a large round mass 10 cm in diameter beside the lower splenic pole and a small amount of ascites. Abdominal ultrasonography (US) 8 hours later showed a large amount of free abdominal fluid and hematoma at the lower splenic pole, yielding a diagnosis of hemoperitoneum caused by rupture of a splenic tumor, necessistating emergency surgery. Opening the peritoneum showed a large amount of blood and a ruptured cystic mass at the lower splenic pole, necessistating splenectomy. Microscopically, the cyst wall was lined with stratified squamous epithelium indicative of an epidermoid splenic cyst. The postoperative course was favorable.

Key words
spontaneous rupture, spleen, epidermoid cyst

Reprint requests
Kuniyasu Murahashi Department of Surgery, Osaka Ekisaikai Hospital
2-1-10 Honden, Nishi-ku, 550-0022 JAPAN

Accepted
October 28, 2009

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