Primary nonparasitic splenic cysts are very rare. Clinical manifestati
ons vary but are often not very typical. Ultrasound and computed tomog
raphy are of use for establishing diagnosis. PL microscopic examinatio
n of the surgical specimen is the only way to make the diagnosis of an
epidermoid cyst. The histological characteristic of an epidermoid cys
t is the presence of an epidermoid epithelial cyst lining of the inner
surface. Treatment requires surgery and is necessary to prevent serio
us complications. Spleen saving surgical procedures are advocated. We
present two cases of young patients with a large epidermoid cyst of th
e spleen who were operated on. On one patient, we had to perform a spl
enectomy because of the size and central localization of the cyst with
compression of the splenic pedicle. On the other patient we managed t
o perform a partial splenectomy.