- True cysts 10%
- Asymptomatic unless >8cm or rupture, bleed or get infected. CA19-9 often elevated
- Simple - Often multiple & peripheral, lined with cuboidal cells
- Dermoid – rare – keratinising epithelium with skin appendages
- Epidermoid – rare – squamous lining
- Pseudocyst 70-80%
- Due to trauma/ infarction
- Parasitic
- Management
- <5cm & asymptomatic
- Observe, unless suspicious feature (irregular wall) – follow with USS
- Symptomatic or >5cm
- Laparoscopic de-roofing/ marsupilise
- Diathermy or harmonic & pack with omentum
- Can recur
- Splenectomy
- Percutaneous drainage usually not recommended
- High recurrence rate (even if inject alcohol)