A Case of a Huge Splenic Cyst with a High Concentration of Carbohydrate Antigen 19-9 in the Cystic Fluid

Abstract

We report a case of a huge splenic cyst with a high concentration of carbohydrate antigen (CA) 19-9 in the cystic fluid. A 35-year-old woman, who first noticed an abdominal mass 5 months prior, was referred to our hospital due to anemia and an enlarged spleen that were observed during routine physical examination. All laboratory results were normal, except for the presence of anemia (hemoglobin, 5.6 g/dl) that was noted during her initial visit. Serum levels of carcinoembryonic antigen and CA19-9 were within the normal range. Abdominal computed tomography revealed a huge cystic lesion (20 X 17 X 14 cm) in the spleen. The patient underwent splenectomy. The spleen weighed 1.4 kg, and 2670 ml of cystic fluid was recovered. The CA19-9 concentration in the cystic fluid was markedly elevated to 34751.0 U/ml. The cystic lesion was histopathologically diagnosed as a true cyst with no evidence of malignancy. True cysts account for approximately 20% of all splenic cysts and are usually idiopathic. Herein, we report a case of a true cyst, with a brief review of the literature.