A giant splenic hamartoma associated with hematologic disorders: A case report

Abstract

IntroductionSplenic hamartoma is a primary benign tumor of the spleen, with approximately 150 cases documented in the literature to date, with only a few cases associated with symptoms and hematologic disorders.Presentation of caseA 49-year-old female with no past medical history, presented to the emergency department complaining of a three-month history of intermittent abdominal pain and 12 kg of weight loss. Physical examination revealed abdominal distension and a big palpable and painless mass on the left side of her abdomen measuring 14 cm. Laboratory tests were significant for anemia and thrombocytopenia, with levels of 9.7 g/dL and 47 × 109/L respectively. Ultrasonography showed splenomegaly with a hypoechoic splenic mass and the computed tomography showed a 14 cm splenic mass with heterogeneous enhancement during the arterial phase. A laparotomy with splenectomy was unremarkably accomplished. Histological examination revealed abnormal red pulp proliferation and showed unorganized sinusoid-like vascular channels, compatible with splenic hamartoma. The patient was discharged on postoperative day 3 without complications. She was seen at the ambulatory clinic 6-months after the surgical procedure with a normal blood count.DiscussionAlthough splenic hamartoma is very rare, it must be included in the differential diagnosis of splenic mass-forming lesions. This type of tumor has some specific radiological features. However, the diagnosis of this disease must be based on clinical features and confirmed by pathology.ConclusionIn patients with splenic tumors, splenectomy is indicated in cases where malignancy cannot be excluded, when symptoms occur, or in the rare cases of consequent hematologic disorders.

Splenic Hamartoma: A Case Report and Literature Review

“…Histologically, they are classified into a red pulp type composed of bizarre sinusoids and a white pulp type containing lymphoid tissue. Most lesions are a mixture of both, with a dominant component [ 5 , 16 ]. Symptomatic cases are invariably of the red pulp type due to its sinusoidal nature, which can sequester cells and result in hypersplenism and expansion [ 13 ].…”

Splenic hamartoma in a patient with peripancreatic arterial arcades: A case report

“…Splenomas are usually incidental findings with an incidence of 0.024%-0.13% [7]. More than 80% of the cases are asymptomatic, and splenic hamartomas are found normally during imaging, surgery, or postmortem [1].…”

“…Splenomas may also cause anemia, thrombocytopenia, or pancytopenia. Other less common symptoms include fever, night sweats, malaise, and spontaneous rupture [7]. This clinical symptomatology seems to occur more often in adults, especially in women [3].…”

Incidentally discovered asymptomatic splenic hamartoma misdiagnosed as an aneurysm: A case report

“…SH is a rare benign tumor that occurs at any age, with a mean age of 27 years for men and 37 years for women, and has equal incidence in males and females[ 5 , 6 ]. The tumor is usually detected incidentally as a singular lesion with a diameter ranging from a few millimeters up to 20 cm[ 7 ], but women seem to have larger lesions, probably due to hormonal influence on tumor growth[ 8 ].…”