Splenic cystic lymphangioma mimicking hydatid cyst in an adult: a rare diagnostic challenge

Splenic cystic lymphangioma is a rare, benign disease affecting the splenic lymphatic system; it is uncommon in adults and primarily seen in children. Symptoms are usually nonspecific. The diagnosis is confirmed by histopathological analysis. We report a 58-year-old female patient with left upper abdominal pain and a history of abdominal trauma with mild tenderness over the left upper quadrant. Abdominal ultrasound revealed a well-defined multilocular cystic lesion in the spleen, measuring ~7.9 × 6.9 cm. Then, abdominal and pelvic computed tomography revealed a large, non-enhancing hypodense cystic lesion in the spleen with internal septations, calcifications, and multiple smaller daughter cysts arranged peripherally; hydatid cyst was the primary differential diagnosis. After that, she underwent an open splenectomy under general anesthesia. Final pathology results confirming a benign splenic cystic lymphangioma. Splenic cystic lymphangiomas are rare, non-malignant tumors that are infrequently diagnosed in adults. Surgical removal via splenectomy is the treatment of choice.