Cystic changes of the spleen are one of the rare clinical entities in the pediatric population. The paper presents a partial splenectomy in children performed by open approach as a safe surgical treatment of giant epithelial splenic cysts. Two cases of giant epithelial cysts of the spleen in children are presented. Medical documents and data referring to age, clinical features, findings on ultrasonography and magnetic resonance imaging (MRI), performed surgery, and follow-ups were collected and analyzed retrospectively. Both of the patients complained of abdominal pain; the diagnosis was made on ultrasound and confirmed by MRI. Open cystectomy with partial resection of the spleen was performed in both cases. There were no complications and no recurrence during the follow-up period. The literature review revealed that up to date only seven authors have published papers on this topic, and different treatment methods and results have been reported. Although very rare, splenic cysts should always be considered in the differential diagnosis of non-specific pain or cystic formations in the upper left quadrant of the abdomen. Taking into account the immunological role of the spleen, tissue preservation surgery should be the main goal. Open partial splenectomy which was performed in both patients was without intraor postoperative complications and uneventful follow-up, and could be one of the safe management options.
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