1Department of Sugery, Saga Prefectural Hospital, 2Department of Internal Medicine, Saga Prefectural Hospital, 3Department of Pathology, Saga Prefectural Hospital
Epidermoid cyst, Spleen, Ultrasound
A 48-year-old woman visited this institution because of pain in the left upper quadrant. A mass that was palpable but not
tender was discovered at the left subcostal region on physical examination, and subsequent imaging studies produced four main
findings. First, abdominal plain x-ray film showed a round calcified mass in left upper quadrant. Second, ultrasound
examination showed a remarkably large cystic mass with a calcified rim near the lower pole of the spleen. There was layering
of two fluids within the cyst: one was almost anechoic; the other was echogenic. The interface between the two fluids was
disarranged and fine bright echoes were scattered throughout the cystic mass when the patient's position was changed. Third,
CT scan showed a homogenous mass that had water density and measured 9 cm in diameter at the lower pole of the spleen.
Calcification of the wall was also noted. Fourth, T1- and T2- weighted MR images of the abdomen showed a spherical mass
with a smooth wall and homogeneously low and high intensity, respectively. The mass was diagnosed as a splenic cyst, and
splenectomy was performed. Histologic exploration of the mass showed it to be an epidermoid cyst. The sonographic
characteristics of this splenic epidermoid cyst are described here.