Huge Littoral Cell Angioma of the Spleen: A Case Report

Littoral Cell Angioma of Spleen: A rare case report

Introduction

Spleen's Littoral Cell Angioma is a rare benign vascular tumor. The main clinical presentation is isolated splenomegaly.

Case presentation

we present the case of a 37 years old male patient who suffers from chronic pain in the left hypochondrium.The abdominal examination finds a painful splenomegaly related to a biological bicytopenia. The CT Scan shows a 32 cm splenomegaly.An exploratory laparotomy with splenectomy was performed. The histological and immunohistochemical study confirmed The final diagnosis of Littoral Cell Angioma.

Clinical discussion

Isolated splenomegaly of unknown etiology is the main clinical sign. Splenectomy is required for a diagnostic purpose and substratum for histological study.

Conclusion

Littoral Cell Angioma of the Spleen is a rare benign vascular tumor, however it should be highlighted by clinical and radiological features, the definitive diagnosis is made upon histological study.

Clinical Landscape of Littoral Cell Angioma in the Spleen Based on a Comprehensive Analysis

Objective

Littoral cell angioma (LCA) is currently considered to be a rare splenic tumor with malignant potential. As the epidemiology, pathogenesis, clinical manifestation, treatment, and prognosis remain unclear, the clinical diagnosis and treatment of LCA have not been standardized. Hence, we performed a comprehensive analysis of 189 observational studies comprising 435 patients to improve the current status of diagnosis and treatment.

Methods

PubMed, Embase, WanFang and CNKI were searched from inception to May 2021 to identify LCA studies that were published in English and Chinese. The clinical information of LCA patients were extracted and analyzed.

Results

The LCA has a male-to-female ratio of 0.90 and a solitary-to-multiple ratio of 0.31. In terms of clinical features, 69.7% of the patients showed splenomegaly, 49.7% were asymptomatic, and 39.2% experienced epigastric discomfort. As the imaging findings of patients with LCA were nonspecific, an image-guided biopsy (10/12) was a safe and effective method for diagnosing in this condition. Notably, results of the prognostic analysis indicated that LCA has a lower risk of recurrence and metastasis. The patient may develop a stable disease or the tumor will grow but will not metastasize. Besides, the novel immunohistochemical pattern of LCA was described as CD31⁺/ERG⁺/FVIII Antigen⁺/CD68⁺/CD163⁺/lysozyme⁺/CD8⁻/WT1⁻.

Conclusion

LCA should be reconsidered as a benign primary splenic vascular neoplasm, which is more like an intra-splenic manifestation of abnormal body function. Image-guided biopsy with follow-up might be a beneficial choice for LCA patients. For LCA patients with abdominal discomfort, pathological uncertainty or continuous tumor enlargement, splenectomy remains the preferred treatment.

A rare vascular tumor of the spleen: Littoral cell angioma

INTRODUCTION

Being a rare benign vascular tumor of the spleen, Littoral cell angioma involves multiple focal nodules in the spleen and splenectomy is used for both definitive diagnosis and treatment.

PATIENTS AND METHODS

A 30-year-old male patient presented to our clinic with the complaints of intermittent abdominal pain and fever. In physical examination, splenomegaly was found and he was further evaluated with ultrasonography, tomography and magnetic resonance imaging that have revealed multiple solid mass lesions of various sizes in his spleen. The patient was administered open splenectomy and recovered uneventful.

RESULTS

After histopathological and immunohistochemical analyses of the splenectomy material, he was diagnosed with Littoral cell angioma.

CONCLUSIONS

For a timely diagnosis, Littoral cell angioma should be considered among the initial diagnoses in patients who were found to have splenomegaly in their physical examination and multiple masses in the spleen in radiological tests.