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Case Report
Complete Regression of a Congenital
Splenic Cyst
Yanki Çelik Yilmazer, MD,1 Ayşe Erden, MD2
1
2
Department of Radiology, Zübeyde Hanim Maternity Hospital, Ankara 06080, Turkey
Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Ankara 06500, Turkey
Received 25 August 1997; accepted 16 September 1997
ABSTRACT: We report a congenital splenic cyst that
was revealed by prenatal sonography at 31 weeks’
gestation. Serial prenatal sonographic examinations
showed a slight enlargement of the cyst. However,
sonography performed when the infant was 7 months
of age showed the cyst had spontaneously and
completely regressed. We recommend that practitioners adopt a more conservative approach in such
infants, one that includes follow-up sonographic examinations, rather than instituting interventional
treatment. © 1998 John Wiley & Sons, Inc. J Clin Ultrasound 26:223–224, 1998.
Keywords: splenic cyst; ultrasonography
C
ongenital splenic cysts are uncommon. To the
best of our knowledge, only 9 cases have been
reported that were identified prenatally by sonography.1–4 We report a case of congenital splenic
cyst that was diagnosed by sonography at 31
weeks’ gestation and followed postnatally until
the cyst had completely regressed.
CASE REPORT
A 12-mm, round cystic lesion located in the left
upper quadrant of the fetus’s abdomen was detected by sonography in a 26-year-old woman
(gravida 1, para 0) when she was first examined
at our clinic at 31 weeks’ gestation. The cystic
lesion was noted to be separate from the stomach
and left kidney and was believed to be located in
either the spleen or the left adrenal gland. No
other fetal or pregnancy-related abnormality was
detected. At 35 weeks’ gestation, the size and
Correspondence to: Y. Ç. Yilmazer, Hüseyin Onat Sokak 11/2,
A. Ayranci Ankara, 06540, Turkey
© 1998 John Wiley & Sons, Inc.
CCC 0091-2751/98/040223-02
shape of the cystic lesion were unchanged. Sonographic examination performed at 38 weeks’ gestation, however, showed that the cystic lesion had
enlarged and was now 14 × 14 mm (Figure 1A). At
40 weeks’ gestation, the patient gave birth vaginally to a viable female infant weighing 3,100 g.
Sonography revealed a unilocular cyst in the
spleen of the newborn. The cyst had regular contours and a size of 17 × 16 mm. Sonography performed when the infant was 2 months of age
showed no change in the size of the cyst (Figure
1B). Sonography at 4 months showed the cyst had
shrunk to 13 × 10 mm and had become ovoid.
Sonography at 7 months showed that the cyst had
completely regressed.
DISCUSSION
Most congenital splenic cysts that have been described in the literature have been either very
large or symptomatic when discovered, and to
prevent infection, rupture, or hemorrhage, the
therapy of choice has been an interventional procedure, such as partial or total splenectomy, cystectomy, laparoscopic puncture, or sonographically guided fine-needle aspiration.1 A splenic
cyst should also be considered in the differential
diagnosis of cystic lesions seen in the fetal left
upper quadrant. With the advent of high-resolution ultrasound equipment and the increasingly
frequent prenatal use of sonography, it has become possible to detect small splenic cysts in fetuses. The prenatal diagnosis of a splenic cyst on
the basis of sonographic findings was first reported in 1988,1 and 9 such splenic cysts have
been reported to date.1–4 This ability to diagnose
these asymptomatic but potentially serious lesions prenatally permits optimal management.2
223
YILMAZER AND ERDEN
FIGURE 1. Congenital splenic cyst. (A) Sonogram at 38 weeks’ gestation shows a cystic lesion (cursors) measuring 14 × 14 mm in the left upper
quadrant of the fetal abdomen. (B) Sonogram at 2 months of age shows a cyst (cursors) measuring 17 × 16 mm. Scans obtained at 7 months
showed complete regression.
Spontaneous postnatal regression of a splenic
cyst was first reported in 1995.3 In our case, the
cyst was found to have shrunk by the 4th month
postnatally and to have completely regressed by
the 7th month. Because a splenic cyst may spontaneously regress and ultimately disappear, we
suggest that a more conservative approach be
adopted instead of interventional procedures,
with their attendant risk of complications. However, infants with these lesions should be carefully followed up because subsequent cyst enlargement would mandate interventional therapy
to prevent cystic rupture or hemorrhage.
224
REFERENCES
1. Lichman JP, Miller EI: Prenatal ultrasonic diagnosis of splenic cyst. J Ultrasound Med 1988;7:637.
2. Stiller RJ, de Regt RH, Choy OG: Antenatal diagnosis of fetal splenic cyst: a case report. J Reprod
Med 1991;36:320.
3. Garel C, Hassan M: Foetal and neonatal splenic
cyst-like lesions: US follow-up of seven cases. Pediatr Radiol 1995;25:360.
4. Okada M, Hata T, Ariyuki Y, et al: Fetal splenic
cyst: change in size and shape with advancing
menstrual age. J Clin Ultrasound 1995;23:204.
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