Splenic Cyst

I was diagnosed with a cyst in my spleen a little over a week ago. I am a 58 year old woman in generally good health otherwise. Over the past 5 or 6 years I have had intermittent pain under my left breast/rib area. Sometimes it would just feel uncomfortable (almost like a too tight bra) and other times very painful for a few minutes almost like a charley horse type pain. Over the last couple of years I also started feeling a dull ache, heavyness/tightness feeling on occasion. It seems to be happening several times per week at night, I wake up with the pain (I don't think the pain itself is bringing me out of a sound sleep, but when I wake during the night the pain is there). For the past year, my PCP has been treating it with Norco 325/5 as needed. I generally take one before bed 8 - 10 times per month at the most. I've been pushing my doctor to figure out what could be causing this and she thought it might be referred pain from my back. I do have bulging discs in my neck and lower back. She ordered an MRI of my thoracic and lower spine. They found the cyst during the MRI.My doctor called me with the results the next day and said "we've found what's been causing your pain all this time". She said I don't have to do anything about it, it's not dangerous, it was definitely just a fluid filled cyst (not cancer), and I should not worry anymore. Should I push for more answers? Should I be worried?

Hello @kellynormand and welcome to Mayo Connect.

Thank you for sharing your story about your symptoms of the cyst in your spleen. It took a while to come up with the correct diagnosis.

Your question about whether you should push for more answers is certainly a valid one. We always encourage Members of Connect to learn as much as they can about their health disorders and seek a second opinion if there is a concern. If you read through the other posts about those diagnosed with cysts on the spleen you will see how others have handled this question and I'm sure somebody will respond to you.

Have you considered a second opinion?

Teresa

Thanks for your response @hopeful33250 - I have an appointment with my PCP next Friday (the 17th) and wanted to start there to get as much detail as I could from her. All I know so far is from the brief phone call from her the day after the MRI and, at first, I was so relieved that they had an answer to this pain after so long, I didn't think to ask any other question. It's only been in this past week that I started reading about it and thinking that I need to know more. So I want to go in and ask some in depth questions - what type of cyst is it, do they even know what type, how big is it, what are the chances of a rupture, what are the chances of it being more than just a cyst, etc. I want to see how many answers I can get from her and then see if she's willing to give me a referral to someone else. My insurance insists on a referral for everything! Any other thoughts on other questions I should be asking?

@kellynormand

Here is some information from Mayo's website, regarding the spleen in general, https://www.mayoclinic.org/diseases-conditions/enlarged-spleen/symptoms-causes/syc-20354326. The questions that you have mentioned in your last post sound like good questions. Also, asking about how often you should have a follow up MRI in order to check the size would be important as well. Since you have had this discomfort for some time now, it is important to know the size and the possibility of rupture.

Asking for a referral to a specialist is good as well, a general surgeon or a hematologist would be good options.

Do you have any other symptoms? Some members have discussed bloating, feeling full quickly after beginning to eat, etc.?

Teresa

Thanks for that info @hopeful33250. I read the link you provided, however, they didn't tell me that my spleen was enlarged at all. In fact just 6 months ago I had a complete physical and the doctor did examine my abdomen and said she didn't feel anything (she specifically did a lot of poking and prodding under my ribs on the left) - wouldn't she have felt if the spleen was enlarged?

I don't have any other symptoms, other than the intermittent pain. I have a very healthy appetite and eat good size meals of very healthy food every day. I do have 3 or 4 drinks each night, but that is the only part of my diet that is not super healthy. I don't eat any white flour, added sugars, I never (I mean actually never, I'm basically militant about only eating food that I cook from scratch) eat in restaurants, don't eat any deep fried foods. I make my own granola and oatmeal and have that with fresh fruit and Greek yogurt for breakfast every day. Lunch is almost always leftovers from the previous night's dinner. Dinners are lean protein, some type of root vegetable, and/or brown rice or whole wheat pasta, another vegetable on the side and/or a salad with organic greens and olive oil and balsamic vinegar dressing. I run several times per week, do yoga, and some P90X resistance workouts. I have had issues at times when the pain would come on (like a charley horse cramp) after a long run, during stretching, but during those times, if I stand up straight, arms overhead, and take slow deep breaths it stops.

The only other physical problems I've been having is I got tendonitis in my left shoulder from too many pushups last December and then by over compensating with my right arm (trying to push through the pain), I have it in my right shoulder as well. I've done 6 weeks of physical therapy for that and am still having some pain with certain movements, but I've been getting back to doing more workouts, keeping up with my PT stretches, and have started swimming a few times a week at my local Y.

I don't have bloating or feeling full - I have noticed that occasionally when I eat a lot of salad I will notice undigested lettuce in my stool, but I thought that was normal.

The very first time I experienced the pain (it was a lot of pain, came on quickly and really scared me, so I remember it well) was about 5 or 6 years ago and I was in the shower shaving my legs. I was bending down to shave my left leg and it felt like someone punched me up under my left rib cage. It actually felt almost like when I was pregnant (my son is now 40) and he would kick me in my ribs! The pain was really intense and (I know this sounds strange), but I swear I felt something move under my rib (that is the only time I've felt that sensation). I stood straight up and panicked at first, I thought I was having a heart attack. Then I raised my arms over my head and took several deep breaths and it totally went away. After that it was only very rare, that first year or so, that I would feel the pain and it would only come on if I bent or twisted a certain way toward the left...so I learned not to do that type of bending. Then it slowly progressed to where I would feel it at other times, but even then it would just come and go. It's only been in the last year to two that I've had the dull pain and ache that I feel at night.

Hi @kellynormand

I am not a medical professional and I have never had any problems with my spleen, so I really can't answer your questions. These are all questions you need to direct to your doctor and perhaps talk with a specialist for a second opinion.

I would be interested in hearing from you after your next appointment. I hope that you get some answers that will put your mind at ease or that you can get a referral for a second opinion.

Please keep in touch!

Teresa

Hi, @kimboski - wondering how you are doing and how it's going with the splenic cyst? Have you thought any further about getting a second opinion?

I had a partial splenectomy for a 15 cm cyst in June 2016. The cyst was an incidental finding on an abdominal ultrasound in 2007. Because I was under 18, I was referred to pediatric oncologists, hematologists, and surgeons for evaluations. After a CT scan, the cyst was actually only 2 cm and rested on the lung side of the spleen. It was suggested by several specialists at that time to just monitor the cyst. The cyst was too small the be concerned about. The surgeon did offer to drain the cyst with a needle under ultrasound but didn’t recommend it due to the cyst sitting directly beside my lung(dangerous) and most likely recurrence of cyst. I chose not to have it drained. I was told if it got larger than 5 cm it would need removed due to risk of rupture, which in turn would rupture my spleen and most likely kill me. I was also told I would definitely know when it got large due to the excruciating pain and unbelievable nausea and vomiting. I then started having abdominal ultrasounds every 6 months. After a couple years of ultrasounds of a 2 cm splenic cyst that wasn’t getting any bigger, I stopped getting the ultrasounds. I felt like they were useless since the doctors wouldn’t remove it unless it was larger than 5 cm and causing me pain. In 2016, I decided to go to the doctor after being constantly sick for the past year, just kept catching everything coming and going and then some. My mother insisted I have an abdominal ultrasound since I hadn’t had one for five years. The ultrasound showed the cyst had grown to 15 cm and a CT scan confirmed. The radiologist reading the ultrasound and my new physician did not think it necessary to seek further tests or see a specialist. After me insisting to be referred to a specialist, I was referred to a hematologist who then referred me to a surgeon. The cyst was pushing on my left lung and stomach, which would explain the lung infection I had just before surgery and a couple months after. I had never had any lung related illnesses until this. I wasn’t in incruciating pain or extreme nausea/vomiting like I was told I would feel. I was experiencing pressure in the upper left side of my body and a little difficulty breathing, which I thought was from a sickness. During surgery my spleen was able to be saved. The dead part of my spleen was removed and the cyst was cut in half and cut from my diaphragm. The cyst was left to preserve my spleen and continuously drains into my abdominal cavity. I went for my last follow up CT scan in January 2018 with my surgeon. I will be getting abdominal ultrasounds yearly for a follow up at my request. I have scar tissue on my diaphragm due to the cyst being cut from it. When I get sick sometimes, the scar tissue gets inflamed and hurts. I was told nothing can be done about it accept maybe some diaphragm exercises. You are the only advocate for your body. You know when something is wrong with your body. Do not trust all doctors’ opinions. In my health experiences with myself and family members, regardless of their medical degrees, some doctors are not educated in a lot of ways that may be necessary to save your life. Research yourself. Find a doctor that is willing to listen to you and your concerns. I have found many good doctors out there also!

I’ve just been told today I have cysts on my spleen after having a ultra sound for what they thought was gallstones, my pain is all on the left side not the right, the doctor told me I need a CT scan in the next few weeks and they will take it from there, I’m really scared and suffer with anxiety not sure what kind of cysts they are and what they do

@maria1969 A cyst is basically a sac of fluid. Sometimes they need to be drained or removed if they are causing problems, Usually they are not harmful except for size or the possibility of tearing. Work with your medical care team and get specifics about your cyst from them. It sounds like they are still determining the exact nature of your cyst and how to deal with it in the best way.