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Eur J Pediatr Surg 2006; 16(6): 415-419
DOI: 10.1055/s-2006-924748
Original Article

Georg Thieme Verlag KG Stuttgart, New York · Masson Editeur Paris

Nonparasitic Splenic Cysts in Children: A Multicentric Study

P. Czauderna1 , P. Vajda2 , K. Schaarschmidt3 , A. Kalman4 , M. Jainsch5 , A. Engelis6 , K. Lewicki1 , T. Verebely4 , J. Koltai5 , A. Petersons6 , A. B. Pintér2
  • 1Department of Surgery and Urology for Children and Adolescents, Medical University of Gdañsk, Poland
  • 2Department of Paediatrics, Faculty of Medicine, Surgical Unit, University of Pécs, Hungary
  • 3Department of Paediatric Surgery, HELIOS Kliniken Berlin-Buch, Germany
  • 4Department of Paediatrics, Surgical Unit, University of Semmelweis, Budapest, Hungary
  • 5Department of Paediatric Surgery, Städtische Kliniken, Frankfurt/Höchst, Germany
  • 6Department of Paediatric Surgery, Riga Stradiņš University, Latvia
Further Information

Publication History

Received: May 1, 2006

Accepted after Revision: May 13, 2006

Publication Date:
08 January 2007 (online)

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Abstract

Purpose: Nonparasitic splenic cysts (NPSCs) are uncommon in children. The aim of this multinational and multicentric study was to present the authors' experience as well as the changing trends in the management of NPSCs over the last 25 years. Material and Methods: From 1981 to 2005, 50 children or adolescents were surgically treated for NPSCs in 6 paediatric surgical centres in four European countries. The medical records of these 50 patients with NPSCs were reviewed retrospectively. Results: Twenty-six male and 24 female patients were operated on. Age at surgery ranged from 1 to 17 years (mean 11.9). Seventeen patients were symptomatic. Six total (4 open and 2 laparoscopic) and 26 partial (22 open and 4 laparoscopic) splenectomies were performed. Laparoscopic fenestration or deroofing and open cystectomy was carried out in 9 patients, respectively. Histological findings revealed the lesion to be an epidermoid cyst (n = 28), a pseudocyst (n = 15) or a mesothelial cyst (n = 2). In 5 patients haemangioma or lymphangioma was the pathological diagnosis. At a mean follow-up of 2.9 years, residual cysts were found in 8 laparoscopically treated patients, 4 of whom required re-do laparoscopy or open surgery. Conclusions: Over the last two decades, the surgical treatment of NPSCs has changed from a formerly customary total splenectomy to spleen-conserving procedures, such as total cystectomy with or without partial splenectomy or partial cystectomy. These therapeutic modalities can be performed laparoscopically, if technically possible. Fenestration or deroofing of the cyst resulted in a high recurrence rate (7/9).

Key words

Spleen - cyst - nonparasitic - surgery - children

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M.D., Professor of Paediatric Surgery Piotr Czauderna

Department of Surgery and Urology for Children and Adolescents
Medical University of Gdansk, Poland

Ul. Nowe Ogrody 1 - 6

80-803 Gdansk

Poland

Email: pczaud@amg.gda.pl