Spontaneous Rupture of an Epidermoid Cyst of the Spleen

We report a rare case of spontaneous rupture of an epidermoid splenic cyst. A 21-year-old woman seen for acute lower abdominal pain onset had normal blood pressure, was not anemic and showed severe pain, tenderness, rebound tenderness, and muscle guarding in the lower abdomen. No abnormal mass was palpable. Abdominal computed tomography (CT) showed a large round mass 10 cm in diameter beside the lower splenic pole and a small amount of ascites. Abdominal ultrasonography (US) 8 hours later showed a large amount of free abdominal fluid and hematoma at the lower splenic pole, yielding a diagnosis of hemoperitoneum caused by rupture of a splenic tumor, necessistating emergency surgery. Opening the peritoneum showed a large amount of blood and a ruptured cystic mass at the lower splenic pole, necessistating splenectomy. Microscopically, the cyst wall was lined with stratified squamous epithelium indicative of an epidermoid splenic cyst. The postoperative course was favorable.