title: Management of non-parasitic splenic cysts: does size really matter?
abstract: BACKGROUND
  Splenic cysts are relatively rare clinical entities and are often diagnosed incidentally upon imaging conducted for a variety of clinical complaints. They can be categorized as primary or secondary based on the presence or absence of an epithelial lining. Primary cysts are further subdivided into those that are and are not secondary to parasitic infection. The treatment of non-parasitic splenic cysts (NPSC) has historically been dictated by two primary factors: the presence of symptoms attributable to the cyst and cyst size greater or less than 5 cm. While it is appropriate to resect a symptomatic lesion, the premise of recommending operative intervention based on size is not firmly supported by the literature.
  
  
  METHODS
  In the current study, we identified 115 patients with splenic cysts and retrospectively reviewed their management that included aspiration, resection, or observation.
  
  
  RESULTS
  Our data reveal a negative overall growth rate of asymptomatic cysts, a high recurrence rate after percutaneous drainage, as well as demonstrate the safety of observing asymptomatic lesions over time.
  
  
  CONCLUSIONS
  We conclude that observation of asymptomatic splenic cysts is safe regardless of size and that aspiration should be reserved for those who are not surgical candidates or in cases of diagnostic uncertainty.
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Kenney
authors.forename: Yumiko E
authors.initials: YE
authors.lastname: Hoeger
authors.forename: Amy K
authors.initials: AK
authors.lastname: Yetasook
authors.forename: John G
authors.initials: JG
authors.lastname: Linn
authors.forename: Ervin W
authors.initials: EW
authors.lastname: Denham
authors.forename: Joann
authors.initials: J
authors.lastname: Carbray
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ujiki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases / Q000628:therapy*; D002648:Child; D003560:Cysts / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D004322:Drainage; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D057832:Watchful Waiting; D055815:Young Adult