Giant Congenital Splenic Cyst in a Pediatric Patient: A Case Report and Review of Surgical Management.

Congenital splenic cysts are rare entities, accounting for approximately 10% of non-parasitic splenic cysts, and are often incidentally discovered. Although many remain asymptomatic, larger lesions may present with abdominal discomfort or complications requiring intervention. We report the case of an 11-year-old boy who presented with chronic abdominal discomfort and back pain and was found on imaging to have a giant splenic cyst measuring 16 × 14.5 cm, located at the upper pole of the spleen with internal echoes and calcifications. The patient underwent a laparoscopic partial splenectomy, during which approximately 1.5 liters of serous fluid were evacuated from the cyst. The postoperative course was uneventful, and the patient was discharged on postoperative day two. Histopathological examination confirmed the diagnosis of a splenic epithelial cyst. Congenital splenic cysts are believed to arise from mesothelial inclusions during embryogenesis. While conservative management may be appropriate for small, asymptomatic lesions, large or symptomatic cysts generally warrant surgical treatment. Spleen-preserving techniques, particularly laparoscopic partial splenectomy, are increasingly favored as they provide symptom relief while maintaining splenic immune function. This case highlights the safety and effectiveness of a minimally invasive, spleen-preserving approach in pediatric patients with giant congenital splenic cysts.