Abstract
A 57-year-old woman had been given a diagnosis of splenic cyst about three years previously and thereafter had been followed up at a local hospital. She consulted our hospital due to symptoms of upper abdominal colic. She had peritoneal irritation symptoms and high serum levels of CA19-9. A splenic cyst was identified on CT scans, but the form and the size had not recently changed and no ascites was observed. Although the administration of conservative therapy relieved the pain, the patient nevertheless underwent a laparoscopic splenectomy due to the recurrent pain. The pathological diagnosis was an epidermoid cyst, and the cyst wall showed hemorrhagic necrosis. The epithelial cells of the cyst showed diffuse immunoreactivity to CA19-9. The postoperative course was uneventful, and the serum CA19-9 levels normalized by one month after the operation. The hemorrhagic necrosis of the cystic wall was therefore presumed to have caused both the abdominal colic pain and high serum levels of CA19-9. We reviewed 29 similar cases of splenic cyst with high serum CA19-9 levels reported in the Japanese literature.
