Single-port Splenectomy after Splenic Cyst Aspiration for Huge Splenic Cyst with High CA 19-9 Levels: The State of the Art

Abstract

Ab s t r Ac t Aim: Description of a patient with an elevation of CA 19-9 levels caused by a giant benign splenic cyst, which was completely laparoscopically resected through a single port, despite the large size of the lesion. An increase in CA 19-9 in this type of cystic tumors does not indicate malignancy. Background: The cystic tumors of the spleen are rare diseases that may present a CA 19-9 increase, without indicating malignancy. There is a tendency to perform surgical intervention as less invasive and aggressive as possible. The current trend in the management of splenic cysts with a CA 19-9 increase and benign radiological characteristics, is a minimally invasive surgery, whenever possible. Case description: We present a case of a young patient with a giant splenic cyst of 20.5 × 14.5 × 23 cm and elevated CA 19-9 levels. Spleen was completely laparoscopically resected through a single port after the cyst puncture and aspiration, using the advantages of laparoscopic surgery and single port. Had a favorably postoperative course with resolution of the symptoms up to the current date. Conclusion: There is an actual tendency to perform minimally invasive surgical interventions. In pathologies such as the clinical case provided, we should try to make a surgical intervention as less invasive as possible, despite the large size of the lesion. In our case, we successfully performed the resection of a giant splenic cyst, using the advantages of laparoscopic surgery and the single port, which helped us in the extraction of the piece. Clinical significance: When facing this pathology, we must bear in mind that benign epithelial and mesothelial cysts can produce an increase of CA 19-9 blood levels, without indicating malignancy. So, we should try to make a surgical intervention as less invasive as possible.