Poster Session：PS 1151 ; Gastroenterology (Pancreatobilliary) : Laparoscopic Fenestration of a Benign Splenic Cyst in Patient Who Elevated Serum CA 19-9 Level = Poster Session：PS 1151 ; Gastroenterology (Pancreatobilliary) : Laparoscopic Fenestration of a Benign Splenic Cyst in Patient Who Elevated Serum CA 19-9 Level

다국어 초록 (Multilingual Abstract)

Because cysts of the spleen are uncommonly encountered in clinical practice, there has been continued to present challenges in treatment. Carbohydrate antigen 19- 9(CA19-9) may be elevated in various clinical situations including mostly pancreatobiliary cancer, but can also be elevated in non-pancreatobiliary cancer or other non-cancerous condition. We experienced a case of splenic cyst with elevated CA19-9 level, which was managed with laparoscopic fenestration. A 29-year-old asymptomatic male was admitted to our hospital. Serum CA19-9 level was elevated(46. 48 U/ml, normal < 27. 0 U/ml). Computed tomography(CT) of abdomen revealed a 10cm-sized thick walled splenic cyst. EGD, colonoscopy, lung and thyroid scan showed no abnormal fi nding. We recommended splenectomy for risk of malignancy, but the patient refused. We managed splenic cyst with laparoscopic aspiration. Histological fi nding of the cyst wall revealed that the lesion was a benign true cyst. There was no malignant cell at aspirated fi uid in the cyst. Twelve days later after aspiration, serum CA19-9 level was normalized(18. 88 U/ml). Follow up CT, checked 5months later after laparoscopic fenestration of splenic cyst, revealed spleen cyst size unchanged. Serum CA19-9 was reelevated(50. 06 U/ml). The patient wanted serial check-up without further treatment. The patient was being well without any complaint 6 months later after laparoscopic procedure of splenic cyst. Ibrahim Akkoyun et al reported that laparoscopic cystectomy, Tomoaki Yoh et al reported that laparoscopic splenectomy for a large multilocular splenic cyst with elevated CA19-9. Percutaneous laparoscopic aspiration with indwelling catheters has been suggested as bridging technique in the management of pseudocysts that will undergo operative resection. But in this case, the patient refused splenectomy, check-up would be neeed. In circumstance that patient refuse operation, fenestration of benign splenic cyst and follw up may be considered. More cases will be needed.