Splenic lymphangioma: a rare benign tumor in adults

Authors

  • Mohammed Raza Department of General Surgery, JSSH, Mysuru, Karnataka, India
  • Preethi S. P. Department of General Surgery, JSSH, Mysuru, Karnataka, India
  • Harish Kumar P. Department of General Surgery, JSSH, Mysuru, Karnataka, India
  • Mir Zeeshan Ali Department of General Surgery, JSSH, Mysuru, Karnataka, India
  • Pranav Jasuja Department of General Surgery, JSSH, Mysuru, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20183847

Keywords:

Lymphangioma, Spleen, Splenectomy

Abstract

Primary benign tumors of the spleen are extremely rare and account for less than 0.007% of all tumors identified upon surgery and autopsy. Splenic lymphangioma is a rare malformation of the splenic lymphatic channels, mostly seen in children. It is characterized by the presence of cysts, resulting from increases in the size and number of thin-walled lymphatic vessels that are abnormally interconnected and dilated. We report the case of 45-year-old female, came with chief complaint of pain abdomen for 1 month. Radiological imaging showed multiple echogenic non-enhancing lesions with septate cystic changes. Splenectomy was done. HPE was reported as Splenic Lymphangioma. The clinical picture is variable; small lesions are often incidentally detected through imaging studies, while larger lesions can result in compression of organs, causing pain or rupture even after minor trauma. Therefore, splenic lymphangiomas should be considered in the differential diagnosis of splenomegaly or left upper quadrant pain even among adults and should be immediately treated with splenectomy; delay in the therapeutic intervention can lead to life-threatening complications.

References

Kosir MA, Sonnino RE, Gauderer MW. Pediatric abdominal lymphangiomas: a plea for early recognition. J Pediatr Surg. 1991;26(11):1309-13.

Davidson AJ, Hartman DS. Lymphangioma of the retroperitoneum: CT and sonographic characteristic. Radiol. 1990;175(2):507-10.

Chang WC, Liou CH, Kao HW, Hsu CC, Chen CY, Yu CY. Solitary lymphangioma of the spleen: dynamic MR findings with pathological correlation. Br J Radiol. 2007;80(949):e4-e6.

Avigad S, Jaffe R, Frand M, Izhak Y, Rotem Y. Lymphangiomatosis with splenic involvement. JAMA. 1976;236(20):2315-7.

Chung SH, Park YS, Jo YJ. Asymptomatic lymphangioma involving the spleen and retroperitoneum in adults. World J Gastroenterol. 2009;15(44):5620-3.

Asch MJ, Cohen AH, Moore TC. Hepatic and splenic lymphangiomatosis with skeletal involvement: report of a case and review of the literature. Surg. 1974;76(2):334-9.

Solomou EG, Patriarheas GV, Mpadra FA, Karamouzis MV, Dimopoulos I. Asymptomatic adult cystic lymphangioma of the spleen: case report and review of the literature. Magn Reson Imaging. 2003;21(1):81-4.

Abbott RM, Levy AD, Aguilera NS, Gorospe L, Thompson WM. From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiograph. 2004;24(4):1137-63.

Wadsworth DT, Newman B, Abramson SJ, Carpenter BL, Lorenzo RL. Splenic lymphangiomatosis in children. Radiol. 1997;202(1):173-6.

Patti R, Iannitto E, Di Vita G. Splenic lymphangiomatosis showing rapid growth during lactation: a case report. World J Gastroenterol. 2010;16(9):1155-7.

Jindal R, Sullivan R, Rodda B. Splenic malformation in a patient with Klippel-Trenaunay syndrome: a case report. J Vasc Surg. 2006;43(4):848-50.

Komatsuda T, Ishida H, Konno K. Splenic lymphangioma: US and CT diagnosis and clinical manifestations. Abdom Imaging. 1999;24(4):414-7.

Moir C, Guttman F, Jequier S, Sonnino R, Youssef S. Splenic cysts: aspiration, sclerosis, or resection. J Pediatr Surg. 1989;24(7):646-8.

Dietz WH Jr, Stuart MJ. Splenic consumptive coagulopathy in a patient with disseminated lymphangiomatosis. J Pediatr. 1977;90(3):421-3.

Economides NG, Benton BF, Fortner TM, Miles RM. Splenic pseudocysts: report of two cases and review of the literature. Am Surg. 1980;46(11):644-8.

Yu X, Yu J, Liang P, Liu F. Real-time contrast-enhanced ultrasound in diagnosing of focal spleen lesions. Eur J Radiol. 2012;81(3):430-6.

Makrin V, Avital S, White I, Sagie B, Szold A. Laparoscopic splenectomy for solitary splenic tumors. Surg Endosc. 2008;22(9):2009-12.

Lam KY, Tang V. Metastatic tumors to the spleen: a 25-year clinicopathologic study. Arch Pathol Lab Med. 2000;124(4):526-30.

Maurus CF, Schäfer M, Müller MK, Clavien PA, Weber M. Laparoscopic versus open splenectomy for nontraumatic diseases. World J Surg. 2008;32(11):2444-9.

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Published

2018-09-25

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Section

Case Reports