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

Abstract

A 9-year-old child was admitted to our hospital for left upper abdominal fullness. Ultrasonqgraphy 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 epithehal cens. Splenectomy was performed under the diagnosis of a splenic epidemoid cyst. The inner surface of the cyst was lined by squamous epitheiium and reacted positively to CA19-9 and CEA immunohistochemical staining.Laboratory studies showed moderately elevated serum CA19-9 1evel (860u/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 knowiedge 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.