Watchful Waiting Phase As Window of Opportunities for Non-pharmaceutical and Non-surgical Management of a Small Splenic Cyst Complicated With Thrombocytopenia.

ABSTRACT

An asymptomatic splenic cyst smaller than 50 mm was detected incidentally at a routine health checkup. Management of the cyst, affected and determined by multiple factors, including force majeure, became difficult and thrombocytopenia developed during watchful waiting. Spontaneous recovery of the spleen did not occur with continued watchful waiting, and thrombocytopenia worsened. However, when a three-month dietary intervention was subsequently implemented, the initiation of recovery was observed. The diet modification was adding to regular meals a daily serving of vegetables prepared following traditional Chinese culinary style. A second course of dietary intervention was undertaken, and accelerated recovery was detected thereafter, with eventual complete resolution of the splenic cyst and thrombocytopenia. This case demonstrates the feasibility and potential benefits of lifestyle intervention for the management of small splenic cysts, including those complicated with thrombocytopenia. Lifestyle intervention, such as dietary intervention, is particularly suitable for the watchful waiting phase since disease management during this time is non-pharmaceutical and non-surgical by nature.