Presentation
Painful splenomegaly
Patient Data
The spleen is enlarged (15 cm long axis) containing a well-defined oval-shaped hypoechoic cystic lesion (8.5 x 7.5 cm) with uniform internal echoes (due to debris).
Enlarged spleen with a well-circumscribed intrasplenic hypodense cystic lesion of homogeneous content. No peripheral rim enhancement. Note small adjacent intrasplenic cysts with wall calcification.
The liver is enlarged with a very small simple cyst in segment VII.
Case Discussion
Ultrasound and CT features of splenic epidermoid cysts
The differential diagnosis includes mainly the secondary cysts:
-splenic pseudocysts: post-traumatic or post-infarction origins
-infection: splenic abscess, splenic hydatid cyst
The large and symptomatic cysts are managed surgically. Small cysts need follow-up.
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