Laparoscopic splenectomy for a lymphangioma of the spleen: report of a case

Laparoscopic partial splenectomy for splenic lymphangioma: a case report

BACKGROUND

Lymphangioma is a benign malformation of the lymphatic system and is often found in the neck and axilla, the orbit, the mediastinum, etc. However, isolated splenic lymphangioma is a rare disease in young women, and its treatment is controversial. We report a case of laparoscopic partial splenectomy for isolated splenic lymphangioma in a young woman.

CASE PRESENTATION

An 18-year-old woman with mild epigastralgia was admitted to a nearby hospital. Abdominal ultrasound detected a 6-cm mass confined to the upper pole of the spleen; thereafter, she was referred to our department for surgical treatment. Although a benign tumor, we decided to resect it because of her symptoms. To preserve part of the normal spleen, laparoscopic partial splenectomy was performed with a co-axial approach using four ports and a liver retractor in the lithotomy position. After dissection around the spleen hilum, we identified that the tumor was being fed from the splenic vessels of the upper pole and severed the branch. Postoperatively, the patient showed no complications and was discharged on postoperative day 8 without symptoms. Pathological examination revealed splenic lymphangioma, which is rare in young women. No recurrence was seen 1 year after surgery, and a computed tomography scan showed no problems with the remaining spleen.

CONCLUSIONS

In our experience of laparoscopic partial splenectomy for a young woman with an isolated splenic lymphangioma, we determined that laparoscopic partial splenectomy is a safe, effective, and valuable option for the treatment of benign splenic tumors.

Splenic lymphangioma

INTRODUCTION

Abdominal localization of cyst lymphangioma is rare. The splenic involvement is exceptional.

CASE PRESENTATION

A 63-year-old woman, who was followed for martial anemia evolving associated with abdominal pain in the past 12 months. On clinical examination, she had pallor conjunctival mucosa, with a normal abdominal and lymph node examination. The abdominal ultrasound showed multiple splenic cysts. The abdominal CT scan showed a normal-sized spleen with multiples hypodense cystic lesions. At the laparotomy exploration a multinodular spleen was found which measured 18 cm*15 cm*6 cm. The histological exam results showed concluded to a splenic cavernous lymphangioma without malignity signs. The follow-up after 12 months was normal.

CONCLUSION

splenic lymphangioma is rare and benign tumor. Total splenectomy under laparotomy or laparoscopy is the appropriate treatment.

Laparoscopic splenectomy for splenic hamartoma: a case report

Hamartoma is a rare splenic benign tumor usually accidentally detected as a radiologic finding. Preoperative diagnosis poses a challenge and thus surgery becomes necessary to confirm the clinical suspicion. Laparoscopic splenectomy has gained consensus as a standard surgical procedure particularly for autoimmune hematological diseases. This former experience has allowed this technique to be extended to other splenic pathologies. Here we report a case of total laparoscopic splenectomy for a bulky splenic hamartoma in a young male patient.

Unusual imaging profile of a solitary splenic lymphangioma

Splenic lymphangioma is a rare, benign lesion of the spleen that is characterized microscopically by a proliferation of thin-walled vascular channels filled by proteinacious material. Based on microscopic features, three types of lymphangiomas are described as simple capillary, cavernous, and cystic; however, the distinction between these types is not uniformly accepted. The cystic type is the most common type and has well described imaging characteristics. However, little is known about the less common cavernous and capillary forms of lymphangioma. Herein, we present a case of a patient with two synchronous colon cancers that presented with a concomitant splenic mass that was initially suspected to be metastatic disease. Despite the use of multiple imaging modalities including computed tomography (CT), magnetic resonance imaging (MRI), nuclear imaging, and contrast-enhanced ultrasound, the final diagnosis of cavernous lymphangioma was made following core needle biopsy of the lesion. A thorough review of literature and this case now demonstrate the difficulty in differentiating atypical forms of splenic lymphangiomas from other benign lesions such as hemangioma.

Splenic lymphangiomatosis showing rapid growth during lactation: A case report

Splenic lymphangiomatosis is a very rare condition that, from 1990 to date, has been described only nine times. In the present report, we describe the first case of splenic lymphangiomatosis with rapid growth during lactation in a 35-year-old woman. We also underline the difficultly in making an accurate preoperative diagnosis, despite more modern imaging techniques. Total splenectomy was considered to be the treatment needed, both to make a definitive diagnosis and to exclude the presence of malignancy.

Asymptomatic lymphangioma involving the spleen and retroperitoneum in adults

Lymphangioma, a benign neoplasm of the lymphatic system, is common in children but rare in adults. Its clinical manifestations include abdominal pain, nausea, vomiting and a palpable mass. However, abdominal sonography or abdominal computed tomography (CT) scan can also incidentally reveal lymphangioma. A larger or symptomatic lymphangioma is treated with total resection to prevent recurrence, infection, torsion and enlargement. Although lymphangioma rarely becomes malignant, its prognosis is generally good. We report a cystic lymphangioma of the spleen and retroperitoneum, which was incidentally found in a 56-year-old man who was hospitalized due to a colon mass. Physical examination showed no specific findings. Abdominal CT revealed a 5.7 cm, non-enhanced multilobulated cystic mass with multiple septa in the spleen and a 10 cm lobulated cystic mass in the paraaortic area. Splenectomy and retroperitoneal resection of the cystic mass were conducted. The endothelium of splenic and retroperitoneal cyst was immunohistochemically stained with D2-40 antibody. The patient was finally diagnosed with splenic cystic and retroperitoneal cavernous lymphangioma.

Laparoscopic Treatment of Simultaneous Splenic Lymphangioma and Non-Hodgkin's Lymphoma: Report of a Case

We report, to the best of our knowledge, the first case of simultaneous splenic lymphangioma and non-Hodgkin's B-cell lymphoma with liver and bone marrow involvement arising in a 69-year-old woman suffering from chronic hepatitis C infection treated with laparoscopic splenectomy followed by polychemotherapy. After 22 months from surgical treatment, the patient is alive without signs of residual disease. According to our experience, laparoscopic splenectomy followed by polychemotherapy seems to be an effective treatment for simultaneous splenic lymphangioma and non-Hodgkin's B-cell lymphoma.