title: Laparoscopic splenectomy for a large multilocular splenic cyst with elevated CA19-9: Report of a case.
abstract: BACKGROUND
  Because splenic cysts are rare, a definitive treatment regime for these cysts remains unclear. We report a case of a large multilocular splenic cyst with elevated carbohydrate antigen 19-9 (CA19-9) levels, which was successfully treated with laparoscopic splenectomy.
  
  
  METHODS
  A 22-year-old female was admitted to our hospital with severe left upper abdominal pain. Serum CA19-9 level was mildly elevated (65U/ml). Computed tomography revealed a 25-cm long spleen with multilocular cystic lesions, for which an emergency laparoscopic splenectomy was performed. Histological findings revealed that the lesion was a benign true cyst, and immunostaining analyses showed that the epithelium was CA19-9-positive.
  
  
  CONCLUSIONS
  Although some spleen-preserving approaches have been reportedly used, splenic cyst recurrence usually occurs in true cyst cases, wherein the cyst is incompletely removed. Most reported cases of splenic cysts producing CA19-9 are true cysts.
  
  
  CONCLUSIONS
  The treatment approach should be decided on the basis of the type, shape, location, and even CA19-9 levels of the splenic cyst.
authors: Department of surgery Yamatotakada municipal hospital, Nara, Japan. Electronic address: tomoakiyoh@yahoo.co.jp.
authors: Tomoaki
authors: T
authors: Yoh
authors: Seidai
authors: S
authors: Wada
authors: Atsushi
authors: A
authors: Kobayashi
authors: Yuya
authors: Y
authors: Nakamura
authors: Tatsushi
authors: T
authors: Kato
authors: Hiroyuki
authors: H
authors: Nakayama
authors: Ryuji
authors: R
authors: Okamura
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