Thorat Santosh, Shaji Febin Mohammed
Department of General Surgery, Pimpri Chinchwad Municipal Corporation's Postgraduate Institute and Yashwantrao Chavan Memorial Hospital, Pune 411018, Maharashtra, India.
World J Clin Oncol. 2023 Oct 24;14(10):440-444. doi: 10.5306/wjco.v14.i10.440.
Primary benign splenic tumours are unique and account for < 0.007% of all tumours identified during surgery and autopsy. Splenic lymphangiomas are rarely seen in adults. Splenic lymphangiomas may be asymptomatic, or may present with upper left abdominal pain, splenomegaly, hypersplenism, or splenic rupture with haemorrhagic shock. The clinical and radiological features of these lesions are not specific. This case report serves to remind the clinician to consider the rare but important differential diagnosis of splenic lymphangioma while treating splenic lesions.
We report a case of splenic lymphangioma in a 22-year-old woman who presented with left upper quadrant abdominal pain for three months. Initial investigations were unremarkable; however, computed tomography later revealed multiple splenic micro-abscesses. The patient underwent laparoscopic splenectomy, and histopathological examination revealed splenic lymphangioma. The patient was discharged on postoperative day three. One month after surgery, the abdominal pain resolved completely, with no new complaints. Splenic lymphangiomas present clinically as splenomegaly or left upper quadrant abdominal pain; prompt intervention is necessary for avoiding complications.
This case report concludes that splenic lymphangiomas should be considered in the differential diagnosis of splenomegaly or left upper quadrant pain, even in adults, because they are amenable to curative treatment. Delays in surgical intervention may lead to severe complications, such as infection, rupture, and hemorrhage. Such lesions can be safely managed with laparoscopy, involving less postoperative pain and early patient discharge with excellent cosmetic outcomes.
原发性脾脏良性肿瘤较为独特,在手术和尸检中发现的所有肿瘤中占比不到0.007%。脾脏淋巴管瘤在成人中很少见。脾脏淋巴管瘤可能无症状,或表现为左上腹疼痛、脾肿大、脾功能亢进,或脾破裂伴失血性休克。这些病变的临床和放射学特征并不特异。本病例报告旨在提醒临床医生在治疗脾脏病变时考虑脾脏淋巴管瘤这种罕见但重要的鉴别诊断。
我们报告一例22岁女性脾脏淋巴管瘤病例,该患者左上腹疼痛3个月。初始检查无异常;然而,计算机断层扫描后来显示多个脾脏微脓肿。患者接受了腹腔镜脾切除术,组织病理学检查显示为脾脏淋巴管瘤。患者术后第3天出院。术后1个月,腹痛完全缓解,无新的不适主诉。脾脏淋巴管瘤临床上表现为脾肿大或左上腹疼痛;为避免并发症,需要及时干预。
本病例报告得出结论,即使在成人中,脾脏淋巴管瘤也应被纳入脾肿大或左上腹疼痛的鉴别诊断中,因为它们可以通过治疗治愈。手术干预延迟可能导致严重并发症,如感染、破裂和出血。此类病变可通过腹腔镜安全处理,术后疼痛较轻,患者可早期出院,美容效果良好。