A congenital splenic cyst is a rare prenatal sonographic finding. This case reports a 17.6 × 15.1-mm cystic structure visualized in the upper pole of the fetal spleen during a sonographic examination of a primigravida woman in her late 20s who presented at an estimated gestational age (EGA) of 36 weeks, 6 days. This finding was not documented in an earlier scan performed at an EGA of 19 weeks. Etiology, pathogenesis, follow-up, treatment, and differential diagnoses associated with congenital splenic cyst are presented.
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