PDF(Pubmed)
Abstract：
Epidermoid cyst of the spleen is a rare disease, and relatively few cases were reported by literatures. Most published case reports provided inadequate information on the impact of splenic epidermoid cyst on tumor markers. A 32-year-old woman with a giant splenic epidermoid cyst was reported, for whom the serum concentration of a collection of tumor markers (CA19-9, CEA, CA125, CA242, and CA50) increased abruptly accompanied by left upper abdominal pain for 5 days. After comprehensive preoperative examination and multidisciplinary team discussion, we ruled out any concurrent malignancy and a laparoscopic total splenectomy was performed, during which the splenic cyst spontaneously ruptured unexpectedly. After surgery, the elevated serum tumor marker levels decreased sharply until reaching normal range 3 months later. Learning from the case, we conclude that interval monitoring of serum tumor markers is of critical value for patients with splenic epidermoid cyst. Abrupt elevation of tumor marker levels and abdominal pain may serve as signs of cyst rupture, which is strongly indicative of surgical intervention as soon as possible. Total removal of the splenic cyst is strongly suggested considering the recurrence and malignant potential of the splenic epidermoid cyst.
摘要：
脾表皮样囊肿是一种罕见的疾病，文献报道的病例相对较少。大多数已发表的病例报告提供的有关脾表皮样囊肿对肿瘤标志物影响的信息不足。据报道，一名32岁的妇女患有巨大的脾表皮样囊肿，一组肿瘤标志物的血清浓度(CA19-9，CEA，CA125，CA242和CA50）突然增加，并伴有左上腹痛5天。经过全面的术前检查和多学科小组讨论，我们排除了任何并发恶性肿瘤，并进行了腹腔镜全脾切除术，在此期间脾囊肿意外自发破裂。手术后,升高的血清肿瘤标志物水平急剧下降，直到3个月后达到正常范围。从案件中学习，我们得出结论，血清肿瘤标志物的间隔监测对脾表皮样囊肿患者具有重要价值。肿瘤标志物水平突然升高和腹痛可能是囊肿破裂的征兆，这强烈表明尽快进行手术干预。考虑到脾表皮样囊肿的复发和恶性潜力，强烈建议完全切除脾囊肿。
