Splenic Cyst

Posted by stew201 @stew201, Jul 15, 2011

After having a CT scan with contrast for a post op mass, an unrelated 11cm cyst was found incidentally on my spleen. This finding has perplexed my primary physician and the hematologist that I was going to be referred to (I have an HMO). I am awaiting bloodwork to determine if the cyst is parasitic, but beyond that, I'm just told to take a wait and see approach if it's not parasitic. Does anyone have any experience with a splenic cyst? Isn't a mass that large on such a small organ dangerous?

Interested in more discussions like this? Go to the Blood Cancers & Disorders Support Group.

@hs314

I am a 26 year old female who is very active and healthy, the only underlying condition I have is Alpha-1 Antitrypsin deficiency. I was exhibiting random spouts of abdominal pain, nausea, and vomiting after eating which is why I was referred to receive the ultrasound of the abdomen and they stumbled upon the cyst. Their findings are such, "Redemonstrated is an anechoic lobulated cystic lesion located at the peripheral anterior aspect of the spleen with a few thin internal
septations and no internal vascularity. The cyst now measures 30 x 22 x 19 mm and is not significantly changed in size from the prior exam performed 3 months ago, previously measuring 31 x 22 x 21 mm at that time." They are saying that it is not related to the pain and nausea I was experiencing, but I am now concerned about this, I am supposed to get it looked at every year to make sure that it is not growing. Any other thoughts on this?

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Hi @hs314, I'd like to add my welcome to @leazard's and also invite @michellern into the discussion.

You may also be interested in these discussions:
- Alpha-1 Antitrypsin Deficiency https://connect.mayoclinic.org/discussion/alpha-1/
- Alpha-1 Antitrypsin Deficiency - just been diagnosed https://connect.mayoclinic.org/discussion/alpha-1-antitrypsin-deficiency-just-been-diagnosed/

I agree to keep asking questions. Has the pain and nausea now subsided or are you still experiencing these symptoms?

REPLY

Hello! I just recently joined the group. I am a 25 year old female in good health. I was very active up until about end of 2017- beginning of 2018. I started having severe back pain. In 2018. I had gotten an MRI for an issue related to my back. It was noted in my file that possible cysts were found, the spleen was not completely shown and it was recommended that I follow up with an ultrasound to confirm. Well, my Primary care doctor was "not concerned" and did not mention it to me. At the time, I did not present with any symptoms, not that I recognized as being an issue anyway.

Fast forward to 2021, I make a visit to the ER. My complaints are chest pain, difficulty breathing, extremely Sharpe pain in the lower part of my ribs with pain that radiates to my shoulder. The PA in the ER does blood tests, X-ray and CT scan. All of which comes back normal, minus my elevated D-Dimer test, which they did not mention to me that was elevated. I found that out myself after reviewing my test results in the patient portal. She comes back and tells me that it was not the blood clot, which is what they thought I was wrong. She advises me that it is most likely just a pulled muscle. She gave me a muscle relaxer and advised I was okay to go home, but did mention they found a spot on my spleen. She gave me the option of getting a second CT scan that night, or following up but advised I do not ignore it. I opted to get it done and over with while I was already in the ER. When the results come back, they advise they appear benign and advised to follow up with my PCP and I could go home.

A week later, I followed up with another PA that they had referred me to. She reviews the tests done in the ER, and agrees it is likely muscle related and no need to worry. She did advised the notes recommended an ultrasound, so she ordered one. The ultrasound confirmed their were 3 simple appearing splenic cysts. The first measures 6.7 X 5.4 X 5.2 cm : second 2.3 X 1.4 X 1.5 : and last 2.5 X1.3 X1.6. The PA that I was referred to by the ER advised I have 3 cyst - most likely normal and no follow up required as there are no symptoms. I have since discussed my situation with other people diagnosed with Splenic Cysts, as my symptoms are very similar and all have recommended a second opinion. I will be seeing a GI doctor later this week, as long as the weather cooperates.

Thanks for reading my story. I am very un-educated on this topic and have been doing a lot of research but would appreciate any advice.

REPLY
@emmie13

Hello! I just recently joined the group. I am a 25 year old female in good health. I was very active up until about end of 2017- beginning of 2018. I started having severe back pain. In 2018. I had gotten an MRI for an issue related to my back. It was noted in my file that possible cysts were found, the spleen was not completely shown and it was recommended that I follow up with an ultrasound to confirm. Well, my Primary care doctor was "not concerned" and did not mention it to me. At the time, I did not present with any symptoms, not that I recognized as being an issue anyway.

Fast forward to 2021, I make a visit to the ER. My complaints are chest pain, difficulty breathing, extremely Sharpe pain in the lower part of my ribs with pain that radiates to my shoulder. The PA in the ER does blood tests, X-ray and CT scan. All of which comes back normal, minus my elevated D-Dimer test, which they did not mention to me that was elevated. I found that out myself after reviewing my test results in the patient portal. She comes back and tells me that it was not the blood clot, which is what they thought I was wrong. She advises me that it is most likely just a pulled muscle. She gave me a muscle relaxer and advised I was okay to go home, but did mention they found a spot on my spleen. She gave me the option of getting a second CT scan that night, or following up but advised I do not ignore it. I opted to get it done and over with while I was already in the ER. When the results come back, they advise they appear benign and advised to follow up with my PCP and I could go home.

A week later, I followed up with another PA that they had referred me to. She reviews the tests done in the ER, and agrees it is likely muscle related and no need to worry. She did advised the notes recommended an ultrasound, so she ordered one. The ultrasound confirmed their were 3 simple appearing splenic cysts. The first measures 6.7 X 5.4 X 5.2 cm : second 2.3 X 1.4 X 1.5 : and last 2.5 X1.3 X1.6. The PA that I was referred to by the ER advised I have 3 cyst - most likely normal and no follow up required as there are no symptoms. I have since discussed my situation with other people diagnosed with Splenic Cysts, as my symptoms are very similar and all have recommended a second opinion. I will be seeing a GI doctor later this week, as long as the weather cooperates.

Thanks for reading my story. I am very un-educated on this topic and have been doing a lot of research but would appreciate any advice.

Jump to this post

Hello @emmie13 and welcome to Mayo Clinic Connect. I read, with interest, your post and I am so glad that you decided to be an advocate for yourself. You checked the results of tests that were said to be OK, questioned the results and began seeking other opinions based on those results. It is extremely important in today's medical environment, where medical professionals are so extremely busy for every patient to do their own research, ask questions, and seek more help when it is needed.

I would like to invite @hs314 @leazard and @michellern to this discussion as they are members of Connect who have also discussed splenic cysts.

If you are comfortable sharing more, could you tell me other factors in your medical history and what level is your discomfort at the present time?

REPLY
@emmie13

Hello! I just recently joined the group. I am a 25 year old female in good health. I was very active up until about end of 2017- beginning of 2018. I started having severe back pain. In 2018. I had gotten an MRI for an issue related to my back. It was noted in my file that possible cysts were found, the spleen was not completely shown and it was recommended that I follow up with an ultrasound to confirm. Well, my Primary care doctor was "not concerned" and did not mention it to me. At the time, I did not present with any symptoms, not that I recognized as being an issue anyway.

Fast forward to 2021, I make a visit to the ER. My complaints are chest pain, difficulty breathing, extremely Sharpe pain in the lower part of my ribs with pain that radiates to my shoulder. The PA in the ER does blood tests, X-ray and CT scan. All of which comes back normal, minus my elevated D-Dimer test, which they did not mention to me that was elevated. I found that out myself after reviewing my test results in the patient portal. She comes back and tells me that it was not the blood clot, which is what they thought I was wrong. She advises me that it is most likely just a pulled muscle. She gave me a muscle relaxer and advised I was okay to go home, but did mention they found a spot on my spleen. She gave me the option of getting a second CT scan that night, or following up but advised I do not ignore it. I opted to get it done and over with while I was already in the ER. When the results come back, they advise they appear benign and advised to follow up with my PCP and I could go home.

A week later, I followed up with another PA that they had referred me to. She reviews the tests done in the ER, and agrees it is likely muscle related and no need to worry. She did advised the notes recommended an ultrasound, so she ordered one. The ultrasound confirmed their were 3 simple appearing splenic cysts. The first measures 6.7 X 5.4 X 5.2 cm : second 2.3 X 1.4 X 1.5 : and last 2.5 X1.3 X1.6. The PA that I was referred to by the ER advised I have 3 cyst - most likely normal and no follow up required as there are no symptoms. I have since discussed my situation with other people diagnosed with Splenic Cysts, as my symptoms are very similar and all have recommended a second opinion. I will be seeing a GI doctor later this week, as long as the weather cooperates.

Thanks for reading my story. I am very un-educated on this topic and have been doing a lot of research but would appreciate any advice.

Jump to this post

Hi, thank you for sharing your story. I currently have one 9 cm cyst on the top of my spleen. It has been stable.for several years. All research I have read recommends having a splenectomy for anything larger than 5 cm. My cyst is complex with a calcium lining around it. Yours are simple cysts. They may be able to go in and drain them. Splenic cysts tend to develope from a past infection or trauma to that area. I technically should have a Spleenectomy due to the size of my cyst. However, I'm a nurse and your spleen is extremely important in fighting infection. If I have my spleen removed then I probably would need to find another career. The ultimate highesy risk is splenic rupture from these cysts Even though it is very rare to happen it is a risk. Keep us posted and good luck. I do not know this if a GI doctor is the person to follow up with. You need to get a second opinion from doctors who specializes in this. Also trying to stick to an anti-inflammatory diet may help. Good luck and keep us posted.

REPLY
@hopeful33250

Hello @emmie13 and welcome to Mayo Clinic Connect. I read, with interest, your post and I am so glad that you decided to be an advocate for yourself. You checked the results of tests that were said to be OK, questioned the results and began seeking other opinions based on those results. It is extremely important in today's medical environment, where medical professionals are so extremely busy for every patient to do their own research, ask questions, and seek more help when it is needed.

I would like to invite @hs314 @leazard and @michellern to this discussion as they are members of Connect who have also discussed splenic cysts.

If you are comfortable sharing more, could you tell me other factors in your medical history and what level is your discomfort at the present time?

Jump to this post

Thank you Teresa! Yes, I’ve been hearing many stories with similar situations, so my fight continues.

I have always been pretty healthy. A few months back I noticed I had a pattern of mentioning to people close to me that my stomach and chest hurts. As far as I can remember is about 3/4 years back. I recently discovered I am prehypertensive, not surprised as my father is being monitored for hypertension. I am still feeling the sharp pain in my lower rib cage, chest pain and some mild shoulder pain. It comes and goes, but recently does not seem to go away for very long.

I mentioned earlier I was going to see a GI, as I’ve been having stomach issues. He is putting me some a medication for 8 weeks and will re assess. He believes I may have acid in my stomach, which he also says is normal.

I am open for more follow ups with other doctors, I just need to research the best doctor to see.

REPLY
@michellern

Hi, thank you for sharing your story. I currently have one 9 cm cyst on the top of my spleen. It has been stable.for several years. All research I have read recommends having a splenectomy for anything larger than 5 cm. My cyst is complex with a calcium lining around it. Yours are simple cysts. They may be able to go in and drain them. Splenic cysts tend to develope from a past infection or trauma to that area. I technically should have a Spleenectomy due to the size of my cyst. However, I'm a nurse and your spleen is extremely important in fighting infection. If I have my spleen removed then I probably would need to find another career. The ultimate highesy risk is splenic rupture from these cysts Even though it is very rare to happen it is a risk. Keep us posted and good luck. I do not know this if a GI doctor is the person to follow up with. You need to get a second opinion from doctors who specializes in this. Also trying to stick to an anti-inflammatory diet may help. Good luck and keep us posted.

Jump to this post

Hello! Your cyst does not cause you any pain? Does your doctor follow up? I haven’t had any injuries, so I am confused as to how these developed. Everything I have read online says the same thing, cysts larger than 5cm and ones that are causing pain are treated. All the doctors I’ve seen say it is not that big and always relate my pain to “likely” be something else. I saw the GI doctor today, he agreed and says not related to spleen, my cyst and spleen are small. He thinks my pain is related to stomach acid. I am getting very different answers. I may try to see another doctor. Are you familiar with the type of doctor I should see and would be able to give me more information on my splenic cysts? Thank you!

REPLY

Hello @emmie13, sorry to hear about your cysts. Doctors dismissing the pain is quite common, but pain in that area (from my research) is actually very common for splenic cysts. A lot of people think it’s to do with increased pressure from the enlarged spleen, as well as nerve pain (which is very often felt in the left shoulder). I still have my cysts. They are very hesitant to operate still unless they grow even larger or my pain increases. I’ve found out what my pain triggers tend to be (sitting upright for long periods of time seems to be #1) and so I’ve been avoiding those. I’m also investigating alternative therapies. The latest suggested to me is a homeopathic treatment, but I haven’t had a chance to speak with an expert about it yet. As someone else mentioned, it’s pretty standard for splenic cysts to be removed if there are more than 1, larger than 5cm, and/or symptomatic. Most doctors are not very well informed about this issue as it’s still relatively rare. A GI doc dismissed me entirely. I persisted and found an Internist who finally did his own research, agreed with me, and referred me to an excellent surgeon. I highly suggest joining the “No Spleen” Facebook group. There are a few people on there who have had cysts and many who explain what life is like after having their spleen removed (many work in healthcare!). If you want to research this further, there are quite a few case studies on PubMed which is usually available through your local library. Never hurts to be informed! Best of luck!

REPLY
@emmie13

Hello! Your cyst does not cause you any pain? Does your doctor follow up? I haven’t had any injuries, so I am confused as to how these developed. Everything I have read online says the same thing, cysts larger than 5cm and ones that are causing pain are treated. All the doctors I’ve seen say it is not that big and always relate my pain to “likely” be something else. I saw the GI doctor today, he agreed and says not related to spleen, my cyst and spleen are small. He thinks my pain is related to stomach acid. I am getting very different answers. I may try to see another doctor. Are you familiar with the type of doctor I should see and would be able to give me more information on my splenic cysts? Thank you!

Jump to this post

Yes my cyst does give me pain at times especially when I'm sick. It's rare I'm ever sick but when I am and my white count is high then it hurts. An internal medicine doc maybe your best bet.

REPLY
@emmie13

Hello! I just recently joined the group. I am a 25 year old female in good health. I was very active up until about end of 2017- beginning of 2018. I started having severe back pain. In 2018. I had gotten an MRI for an issue related to my back. It was noted in my file that possible cysts were found, the spleen was not completely shown and it was recommended that I follow up with an ultrasound to confirm. Well, my Primary care doctor was "not concerned" and did not mention it to me. At the time, I did not present with any symptoms, not that I recognized as being an issue anyway.

Fast forward to 2021, I make a visit to the ER. My complaints are chest pain, difficulty breathing, extremely Sharpe pain in the lower part of my ribs with pain that radiates to my shoulder. The PA in the ER does blood tests, X-ray and CT scan. All of which comes back normal, minus my elevated D-Dimer test, which they did not mention to me that was elevated. I found that out myself after reviewing my test results in the patient portal. She comes back and tells me that it was not the blood clot, which is what they thought I was wrong. She advises me that it is most likely just a pulled muscle. She gave me a muscle relaxer and advised I was okay to go home, but did mention they found a spot on my spleen. She gave me the option of getting a second CT scan that night, or following up but advised I do not ignore it. I opted to get it done and over with while I was already in the ER. When the results come back, they advise they appear benign and advised to follow up with my PCP and I could go home.

A week later, I followed up with another PA that they had referred me to. She reviews the tests done in the ER, and agrees it is likely muscle related and no need to worry. She did advised the notes recommended an ultrasound, so she ordered one. The ultrasound confirmed their were 3 simple appearing splenic cysts. The first measures 6.7 X 5.4 X 5.2 cm : second 2.3 X 1.4 X 1.5 : and last 2.5 X1.3 X1.6. The PA that I was referred to by the ER advised I have 3 cyst - most likely normal and no follow up required as there are no symptoms. I have since discussed my situation with other people diagnosed with Splenic Cysts, as my symptoms are very similar and all have recommended a second opinion. I will be seeing a GI doctor later this week, as long as the weather cooperates.

Thanks for reading my story. I am very un-educated on this topic and have been doing a lot of research but would appreciate any advice.

Jump to this post

@emmie13 you are the best advocate for your self. Even doctors can be ignorant. I had a 15cm splenic cyst “removed” in June 2016 that was initially found in 2006 only being 2cm. I was informed by multiple specialists the cyst needed to be removed once 5cm+ due to rupturing. I went for routine ultrasounds to monitor it for 5yrs. It was growing VERY SLOWLY. I stopped going for ultrasounds. Then, in 2015 I was nonstop sick, vitamin deficient, low iron, anemic, felt pressure in my left side, & lingering cough due to infections constantly setting in my left lung. Went for ultrasound & CT scan before being sent to a surgeon. A general surgeon that specializes in Hepatobiliary & Pancreatic Surgery “removed” it. I use the word “removed” loosely because in order to preserve my spleen, the surgeon cut the cyst into(capsized it) & cauterized edges. This will allow the remaining cyst to drain into the abdominal cavity, while I get to keep 75% of my spleen for immunity. Stay positive, stand up for your self, & be confident when doing so. I can’t tell you how many times I had to do this throughout the 6months leading up to surgery due to IGNORANCE with doctors.

REPLY
@emmie13

Thank you Teresa! Yes, I’ve been hearing many stories with similar situations, so my fight continues.

I have always been pretty healthy. A few months back I noticed I had a pattern of mentioning to people close to me that my stomach and chest hurts. As far as I can remember is about 3/4 years back. I recently discovered I am prehypertensive, not surprised as my father is being monitored for hypertension. I am still feeling the sharp pain in my lower rib cage, chest pain and some mild shoulder pain. It comes and goes, but recently does not seem to go away for very long.

I mentioned earlier I was going to see a GI, as I’ve been having stomach issues. He is putting me some a medication for 8 weeks and will re assess. He believes I may have acid in my stomach, which he also says is normal.

I am open for more follow ups with other doctors, I just need to research the best doctor to see.

Jump to this post

Hello again @emmie13,

I went back and read your previous posts about your history with this problem. Have you considered getting a second opinion at a multi-disciplinary health care facility? I'm thinking about a university medical school or a facility like Mayo Clinic. These organizations are research-oriented and are very good at diagnosing but also in educating patients about their disorders.

If you choose to make an appointment at one of these health care centers be sure to talk about the pain you experience. If possible. try to keep a journal of your pain and discuss when it is at its worst. For example, is it worse after a heavy meal, or after exercise, etc.? You might also consider eating smaller, more frequent meals to see if that helps.

I'm assuming that your GI doctor did an upper endoscopy. If not, that might be a good way to rule out other causes or your discomfort.

Will you post again and let me know how you are feeling and how you are doing seeking answers?

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