Gastrointestinal: Case of accidentally discovered splenic epidermoid cyst with serum CA 19-9 elevation

摘要

A 36-year old woman underwent upper gastrointestinal examination during a routine medical examination, which revealed an abnormality (Fig. la). She was admitted for further examination. She had no symptoms and her abdomen showed no obvious abnormality with palpation. Computed tomographic scan revealed an abdominal low-density tumor, which measured 8 cm in diameter, with partial calcification close to the stomach and spleen (Fig. lb). She had no history of significant abdominal trauma. Results of physical and laboratory examinations were normal except for elevation of serum CA19-9 (carbohydrate antigen 19-9) levels of 244.4 U/ml. Surgical exploration suggested that a huge tumor originated from the spleen. Because malignancy and risk of rupture could not be denied, she underwent splenectomy. The excised specimen was a cystic lesion measuring 8.5 x 7.5 x 5.5 cm with necrosis and bleeding (Fig. lc). Histopathologically, the removed specimen showed a unicystic lesion surrounded by splenic tissue with marked fibrosis and calcification (Fig. 2a).