Nontraumatic splenic pseudocyst. Case report.

Background: Splenic cysts are uncommon and are classified as true cysts (with epithelial lining) and false cysts or pseudocysts. Splenic pseudocysts usually have a posttraumatic origin and are secondary to hematoma or to splenic infarction. At times there is no prior evidence of trauma, and the cyst may be secondary to a primary cyst with degeneration/atrophy of the epithelial lining.

Clinical Case: We present the case of a 50-year-old female with negative history of abdominal trauma. Clinically, the patient reported discomfort and pain in the left upper abdomen. Physical examination revealed a palpable and painful mass. reoperative ultrasonography and computerized tomography showed a large cyst in the spleen. Laparotomy and total splenectomy was performed. The cyst measured 9.5 × 9.0 cm. Histologically, the wall was composed of thick fibrous tissue, calcifications and no epithelial lining.

Conclusions: "Nontraumatic" splenic pseudocyst is rare and may be secondary to a primary cyst with degenerative/atrophic changes in the epithelium. Clinically it is nonspecific, and symptoms are related to the mass effect of the cyst. Recommended treatment, according to the size of the cyst and its anatomic relation with the vasculature, is surgical with partial or complete splenectomy.