Abstract
The patient was a 23-year-old woman who had been pointed out a splenic cyst 5.0 cm in diameter by abdominal ultrasonography for exploration of anemia one year earlier. Thereafter the cyst enlarged to 8.8 cm in diameter and left lateral abdominal pain occurred. The patient was considered to be a candidate for surgery and underwent laparoscopic dome resection. The histopathological diagnosis was epithelial cyst of the spleen. The postoperative course was uneventful and she was discharged from the hospital. Three weeks later, however, she developed left upper quadrant pain of the abdomen. Abdominal ultrasonography and CT scan showed a recurrent cyst about 7 cm in diameter, so that laparoscopic dome resection was extensive performed again and resection of the cystic wall around the splenic hilum was added. In both initial and second operations, the inner wall of the cyst was cauterized by argon beam coagulator. No more recurrence has occurred, as of eight months after the second operation.
Since splenic cysts predominantly affect young women and are rarely malignant, laparoscopic dome resection which can preserve the splenic function and offers cosmetic benefits is considered to be a useful operative procedure. However, the procedure entails a risk of recurrence in some cases and then much attention should be paid to the possibility in performing surgery as well as in observing the clinical course.
