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成人极罕见孤立性脾淋巴管瘤的腹腔镜解剖性部分脾切除术:病例报告及文献复习

Laparoscopic anatomical partial splenectomy for extremely rare isolated splenic lymphangioma in an adult: a case report and literature review.

作者信息

Shi Ruizi, Yang Pei, Guo Yangjie, Tang Yiping, Luo Hua, Qin Chuan, Jiang Ting, Huang Yu, Gao Ziqing, Zeng Xintao, Wang Jianjun

机构信息

Department of Hepatobiliary Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.

Department of Pathology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.

出版信息

Front Oncol. 2024 Sep 4;14:1460566. doi: 10.3389/fonc.2024.1460566. eCollection 2024.

Abstract

BACKGROUND

Benign tumors of the spleen are rare compared to those of other parenchymal organs, accounting for less than 0.007% of all tumors, and are often found incidentally. Splenolymphangiomas are much rarer, commonly occur in children, and tend to have multiple foci. Splenic lymphangiomas are rare in adults, and fewer than 20 adult patients with isolated splenic lymphangiomas have been reported. In this article, we report the case of a middle-aged female patient with isolated splenic lymphangioma who underwent laparoscopic anatomical hypophysectomy of the lower pole of the spleen. We also summarize the existing literature on splenic lymphangioma diagnosis and available treatment options.

CASE PRESENTATION

A 58-year-old middle-aged woman was found to have a mass approximately 60 mm in diameter at the lower pole of the spleen during a health checkup that was not accompanied by other symptoms or examination abnormalities. After completing a preoperative examination with no contraindications to surgery, the patient underwent laparoscopic anatomical splenectomy of the lower extremity of the spleen. The patient recovered well without complications and was discharged from the hospital on the 7th postoperative day. Histopathological and immunohistochemical results confirmed the diagnosis of splenic lymphangioma. Prompt surgical intervention is safe and necessary when splenic lymphangiomas are large or associated with a risk of bleeding.

CONCLUSION

Splenic lymphangiomas are rare and require early surgical intervention in patients with large tumor diameters or those at risk of rupture and bleeding. After rigorous preoperative evaluation and preparation, laparoscopic anatomical partial splenectomy is safe and feasible for surgeons with experience in laparoscopic surgery.

摘要

背景

与其他实质器官的肿瘤相比,脾脏良性肿瘤较为罕见,占所有肿瘤的比例不到0.007%,且常为偶然发现。脾淋巴管瘤更为罕见,常见于儿童,且往往有多个病灶。脾淋巴管瘤在成人中罕见,报道的孤立性脾淋巴管瘤成年患者少于20例。在本文中,我们报告了一例接受腹腔镜脾脏下极解剖性脾切除术的中年女性孤立性脾淋巴管瘤患者的病例。我们还总结了关于脾淋巴管瘤诊断及现有治疗选择的文献。

病例介绍

一名58岁中年女性在健康体检时发现脾脏下极有一个直径约60 mm的肿块,无其他症状或检查异常。在完成术前检查且无手术禁忌证后,患者接受了腹腔镜脾脏下极解剖性脾切除术。患者恢复良好,无并发症,术后第7天出院。组织病理学和免疫组化结果证实为脾淋巴管瘤。当脾淋巴管瘤较大或有出血风险时,及时的手术干预是安全且必要的。

结论

脾淋巴管瘤罕见,对于肿瘤直径较大或有破裂出血风险的患者需要早期手术干预。经过严格的术前评估和准备后,腹腔镜解剖性部分脾切除术对于有腹腔镜手术经验的外科医生来说是安全可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c099/11408321/e37a0c356de7/fonc-14-1460566-g001.jpg

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