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JAMA Surgery Clinical Challenge
April 2015

Splenic Cyst

Author Affiliations
  • 1Department of Surgery, University of Iowa, Iowa City
  • 2Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa
JAMA Surg. 2015;150(4):365-366. doi:10.1001/jamasurg.2014.852

A woman in her 30s was referred for evaluation of a large splenic cyst identified on a computed tomographic (CT) scan. She had previously lived in Beijing, China. In 2011, she was evaluated in a Chinese clinic for abdominal bloating and moderate left upper quadrant pain; she was offered a splenectomy, but she declined and pursued a second opinion at a hospital in the United States in 2012. During that evaluation, the patient reported that she had run in areas with dog feces on the ground and had eaten sheep meat (notably, not organ meat); she denied consuming canine meat. Results of serologic tests for Echinococcus antibody IgG were negative. Results of a CT scan were remarkable for a 9.7 × 9.0 × 10.5-cm anterior cyst and a smaller posterior cyst measuring 4.6 × 4.7 × 3.8 cm, both with rim calcifications (Figure 1).

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