Skip to main content
SpringerLink
Log in

Percutaneous Treatment of Non-parasitic Splenic Cysts: Long-Term Results for Single- Versus Multiple-Session Treatment

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate the efficacy and safety of percutaneous sclerotherapy for non-parasitic splenic cysts (NPSCs). The secondary aims were to introduce puncture-aspiration-injection-reaspiration (PAIR) technique in the treatment of NPSCs and to compare multiple- and single-session techniques.

Materials and Methods

This retrospective study included 24 (17 females, 7 males) patients, treated between the years 1997 and 2015. Three techniques were used. Group A (n = 8), Group B (n = 6) and Group C (n = 10) were treated by PAIR, single-session catheterization and multiple-session catheterization, respectively. Since both PAIR and single-session catheterization techniques are carried out in a single session, Group A and Group B were evaluated in one group (Group A + B). Group A + B was compared with Group C in terms of patient demographics, the initial volume of the cysts, follow-up periods, complication and hospitalization rates and follow-up results. Recurrence and reduction rates were evaluated for two groups.

Results

Technical success rate was 100%. The mean follow-up period was 68.9 months. Recurrence detected in 7 (29.1%) patients. Final reduction rate was between 40.7 and 100% (median 96.4%) with a significant difference in cyst volume (p < 0.05). There was no significant difference regarding recurrence rates (p = 1) and the final reduction rates (p = 0.51) between the two groups.

Conclusion

Percutaneous sclerotherapy is a minimally invasive technique, preserving maximum tissue while effectively treating NPSCs. Single-session sclerotherapy which reduces hospitalization days and increases patient comfort is as effective as multi-session sclerotherapy as the initial procedure. This study supports that single-session sclerotherapy should be a valid treatment option.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Fowler RH. Cystic tumors of the spleen. Int Abstr Surg. 1940;70:213–23.

    Google Scholar 

  2. Martin JW. Congenital splenic cysts. Am J Surg. 1958;96:302–8 (Cross ref.).

    Article  CAS  PubMed  Google Scholar 

  3. Morgenstern L. Nonparasitic splenic cysts: pathogenesis, classification, and treatment. J Am Coll Surg. 2002;194(3):306–14.

    Article  PubMed  Google Scholar 

  4. Hansen MB, Moller AC. Splenic cysts. Surg Laparosc Endosc Percutaneous Tech. 2004;14(6):316–22.

    Article  Google Scholar 

  5. Williams RJ, Glazer G. Splenic cysts: changes in diagnosis, treatment, and aetiological concepts. Ann R Coll Surg Engl. 1993;75:87–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Musy PA, Roche B, Belli D, Bugmann P, Nussle D, Le Coultre C. Splenic cysts in pediatric patients a report on 8 cases and review of the literature. Eur J Pediatr Surg. 1992;2:137–40.

    Article  CAS  PubMed  Google Scholar 

  7. Till H, Schaarschmidt K. Partial laparoscopic decapsulation of congenital splenic cysts. A medium-term evaluation proves the efficiency in children. Surg Endosc. 2004;18:626–8.

    Article  CAS  PubMed  Google Scholar 

  8. Marusch F, Koch A, Zippel R, Muth CP, Gastinger I. Laparoscopy of a traumatic rupture of a dysontogenetic splenic cyst. A case report. Surg Endosc. 2001;15:759.

    Article  CAS  PubMed  Google Scholar 

  9. Spence RA, Dane TE. Spontaneous rupture of an epithelial cyst of the spleen. Postgrad Med J. 1983;59:65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Dillemas B, Mootrie A, Decoster M, Gruwez JA. Epidermoid cysts of the spleen. Acta Chir Belg. 1993;93:265–7.

    Google Scholar 

  11. Wu G, Zhao Q, Wang W, Chen D, Shi H, Zhao Z, et al. Ex vivo resection of giant epidermoid cyst and vascularized partial splenic autotransplantation: 3.5-year follow-up. Surgery. 2015;158(6):1734–7.

    Article  PubMed  Google Scholar 

  12. Bean WJ, Rodan B. Hepatic cysts: treatment with alcohol. Am J Radiol. 1985;144:237–41.

    CAS  Google Scholar 

  13. Bean WJ. Renal cysts: treatment with alcohol. Am J Radiol. 1981;138:329–32.

    Article  CAS  Google Scholar 

  14. Akhan O, Islim F, Balci S, Erbahceci A, Akpınar B, Ciftci T, et al. Percutaneous treatment of simple hepatic cysts: the long-term results of PAIR and catheterization techniques as single-session procedures. Cardiovasc Intervent Radiol. 2016;39(6):902–8.

    Article  PubMed  Google Scholar 

  15. Akinci D, Gumus B, Ozkan OS, Ozmen MN, Akhan O. Single-session percutaneous ethanol sclerotherapy in simple renal cysts in children: long-term follow-up. Pediatr Radiol. 2005;35(2):155–8.

    Article  PubMed  Google Scholar 

  16. Akinci D, Akhan O, Ozmen M, Gumus B, Ozkan O, Karcaaltincaba M, et al. Long-term results of single-session percutaneous drainage and ethanol sclerotherapy in simple renal cysts. Eur J Radiol. 2005;54(2):298–302.

    Article  PubMed  Google Scholar 

  17. Akhan O, Karcaaltincaba M, Ozmen MN, Akinci D, Karcaaltincaba D, Ayhan A. Percutaneous transcatheter ethanol sclerotherapy and catheter drainage of postoperative pelvic lymphoceles. Cardiovasc Intervent Radiol. 2007;30(2):237–40.

    Article  PubMed  Google Scholar 

  18. Akhan O, Canyigit M, Kaya D, Koksal A, Akgoz A, Yucesoy C, et al. Long-term follow-up of the percutaneous treatment of hydatid cyst in the adrenal gland: a case report and review of the literature. Cardiovasc Intervent Radiol. 2011;34(Suppl 2):S256–9.

    Article  PubMed  Google Scholar 

  19. Singh AK, Shankar S, Gervais DA, Hahn PF, Mueller PR. Image-guided percutaneous splenic interventions. Radiographics. 2012;32(2):523–34.

    Article  PubMed  Google Scholar 

  20. Anon R, Guijarro J, Amoros C, Gil J, Bosca MM, Palmero J, et al. Congenital splenic cyst treated with percutaneous sclerosis using alcohol. Cardiovasc Intervent Radiol. 2006;29:691–3.

    Article  PubMed  Google Scholar 

  21. Goktay AY, Secil M, Ozcan MA, Dicle O. Percutaneous treatment of congenital splenic cysts: drainage and sclerotherapy with polidocanol. Cardiovasc Intervent Radiol. 2006;29:469–72.

    Article  PubMed  Google Scholar 

  22. Rifai K, Berger D, Potthoff A, Manns MP, Gebel MJ. Fine needle sclerotherapy as a new effective therapeutic approach for nonparasitic splenic cysts: a case series. Dig Liver Dis. 2013;45(7):595–9.

    Article  PubMed  Google Scholar 

  23. Shimanuki K, Satake M. Non-surgical treatment of splenic cyst, using with installation of minocycline chloride. Fukushima J Med Sci. 1996;42:23–30.

    CAS  PubMed  Google Scholar 

  24. Akhan O, Baykan Z, Oguzkurt L, Sayek I, Ozmen MN. Percutaneous treatment of a congenital splenic cyst with alcohol: a new therapeutic approach. Eur Radiol. 1997;7:1067–70.

    Article  CAS  PubMed  Google Scholar 

  25. Campbell S, Goessens L, Goswamy R, Whitehead M. Realtime ultrasonography for determination of ovarian morphology and volume. A possible early screening test for ovarian cancer? Lancet. 1982;1:425–6.

    Article  CAS  PubMed  Google Scholar 

  26. Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of ınterventional radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14:199–202.

    Article  Google Scholar 

  27. Dachman AH, Ros PR, Murari PJ, Olmsted WW, Lichtenstein JE. Nonparasitic splenic cysts: a report of 52 cases with radiologic-pathologic correlation. AJR Am J Roentgenol. 1986;147(3):537–42.

    Article  CAS  PubMed  Google Scholar 

  28. Dawes LG, Malangoni MA. Cystic masses of the spleen. Am Surg. 1986;52(6):333–6.

    CAS  PubMed  Google Scholar 

  29. Kimber C, Spitz L, Drake D, Kiely E, Westaby S, Cozzi F, et al. Elective partial splenectomy in childhood. J Pediatr Surg. 1998;33:826–9.

    Article  CAS  PubMed  Google Scholar 

  30. Sinha CK, Agrawal M. Nonparasitic splenic cysts in children: current status. Surgeon. 2011;9(1):49–53.

    Article  CAS  PubMed  Google Scholar 

  31. Karfis EA, Roustanis E, Tsimoyiannis EC. Surgical management of nonparasitic splenic cysts. JSLS. 2009;13(2):207–12.

    PubMed  PubMed Central  Google Scholar 

  32. Fisher JC, Gurung B, Cowles RA. Recurrence after laparoscopic excision of nonparasitic splenic cysts. J Pediatr Surg. 2008;43(9):1644–8.

    Article  PubMed  Google Scholar 

  33. Chin EH, Shapiro R, Hazzan D, Katz LB, Salky B. A ten-year experience with laparoscopic treatment of splenic cysts. JSLS. 2007;11(1):20–3.

    PubMed  PubMed Central  Google Scholar 

  34. Calligaris L, Bortul M. Laparoscopic treatment of a nonparasitic splenic cyst: case report. J Laparoendosc Surg. 1996;6:431–4.

    Article  CAS  PubMed  Google Scholar 

  35. Seshadri PA, Poenaru D, Park A. Laparoscopic splenic cystectomy: a case report. J Pediatr Surg. 1998;33:1439–40.

    Article  CAS  PubMed  Google Scholar 

  36. Dietrich CF, Lorentzen T, Appelbaum L, Buscarini E, Cantisani V, Correas JM, et al. EFSUMB guidelines on ınterventional ultrasound (INVUS), Part III abdominal treatment procedures (Short Version). Ultraschall Med. 2016;37(1):27–45.

    Article  CAS  PubMed  Google Scholar 

  37. Jequier S, Guttman F, Lafortune M. Non-surgical treatment of a congenital splenic cyst. Pediatr Radiol. 1987;17:248–9.

    Article  CAS  PubMed  Google Scholar 

  38. Moir C, Guttman F, Jequier S, Sonnino R, Youssef S. Splenic cysts: aspiration, sclerosis, or resection. J Pediatr Surg. 1989;24:646–8.

    Article  CAS  PubMed  Google Scholar 

  39. Yoshikane H, Suzuki T, Yoshioka N, Ogawa Y, Hayashi Y, Hamajima E, et al. Giant splenic cyst with high serum concentration of CA 19-9. Failure of treatment with percutaneous transcatheter drainage and injection of tetracycline. Scand J Gastroenterol. 1996;31:524–6.

    Article  CAS  PubMed  Google Scholar 

  40. De Caluwd D, Phelan E, Puri P. Pure alcohol injection of a congenital splenic cyst: a valid alternative? [Tratamiento del quiste esplLnico no parasitario con inyecciFn percut Mnea de alcohol.]. Gastroenterol Hepatol. 2003;24:199–201 (cross ref).

    Google Scholar 

  41. Lopez Cano A, Munoz Benvenuty A, Mendez Perez C, Herrera M, Ortiz Acero I, et al. Tratamiento del quiste esplLnico no parasitario con inyecciFn percut Mnea de alcohol. Gastroenterol Hepatol. 2001;24:199–201 (cross ref).

    Article  CAS  PubMed  Google Scholar 

  42. Thanos L, Myolona S, Ntai S, Pomoni M, Batakis N, et al. Percutaneous treatment of true splenic cyst: report of two cases. Abdom Imaging. 2005;30:773–6.

    Article  CAS  PubMed  Google Scholar 

  43. Akhan O, Akkaya S, Dağoğlu MG, Akpınar B, Erbahçeci A, Çiftçi T, et al. Percutaneous treatment of splenic cystic echinococcosis: results of 12 cases. Cardiovasc Intervent Radiol. 2016;39(3):441–6.

    Article  PubMed  Google Scholar 

  44. Zerem E, Nuhanović A, Caluk J. Modified pair technique for treatment of hydatid cysts in the spleen. Bosn J Basic Med Sci. 2005;5(3):74–8.

    PubMed  Google Scholar 

  45. Taşar M, Uğurel MS, Kocaoğlu M, Sağlam M, So-muncu I. Computed tomography-guided percutaneous drainage of splenic abscesses. Clin Imaging. 2004;28(1):44–8.

    Article  PubMed  Google Scholar 

  46. Lucey BC, Boland GW, Maher MM, Hahn PF, Gervais DA, Mueller PR. Percutaneous nonvascular splenic intervention: a 10-year review. AJR Am J Roentgenol. 2002;179(6):1591–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Hacettepe University School of Medicine, 6100, Sihhiye, Ankara, Turkey

    Okan Akhan, Turkmen Ciftci & Devrim Akinci

  2. Department of Radiology, Istanbul University Istanbul Medical School, 34093, Çapa, Fatih, Istanbul, Turkey

    Merve Gulbiz Dagoglu-Kartal

  3. Numune Training and Research Hospital Radiology Clinic, Ülkü Mahallesi Talatpaşa Bulvari No: 5, Altindag, 6080, Ankara, Turkey

    Cigdem Ozer

  4. Sadi Konuk Training and Research Hospital Radiology Clinic, Tevfik Saglam Caddesi No: 11, Zuhuratbaba, 34147, Istanbul, Turkey

    Aysun Erbahceci

Authors
  1. Okan Akhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Merve Gulbiz Dagoglu-Kartal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Turkmen Ciftci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cigdem Ozer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aysun Erbahceci
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Devrim Akinci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Okan Akhan.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Akhan, O., Dagoglu-Kartal, M.G., Ciftci, T. et al. Percutaneous Treatment of Non-parasitic Splenic Cysts: Long-Term Results for Single- Versus Multiple-Session Treatment. Cardiovasc Intervent Radiol 40, 1421–1430 (2017). https://doi.org/10.1007/s00270-017-1650-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-017-1650-0

Keywords

Search

Navigation