Case Report
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World J Gastroenterol. Aug 14, 2014; 20(30): 10637-10641
Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10637
Symptomatic multinodular splenic hamartoma preoperatively suspected as metastatic tumor: A case report
Rui-Tao Wang, Xin-Sen Xu, Hui-Lian Hou, Kai Qu, Ji-Gang Bai
Rui-Tao Wang, Xin-Sen Xu, Kai Qu, Ji-Gang Bai, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Hui-Lian Hou, Department of Pathology, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Wang RT and Bai JG designed the report; Wang RT and Xu XS wrote the paper; Hou HL collected the patient’s clinical data; Hou HL and Qu K analyzed the data and revised the paper.
Correspondence to: Ji-Gang Bai, MD, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xianningxi Road 28, Xi’an 710061, Shaanxi Province, China. bjgxa@126.com
Telephone: +86-29-85323900 Fax: +86-29-85323895
Received: January 6, 2014
Revised: January 26, 2014
Accepted: April 30, 2014
Published online: August 14, 2014
Processing time: 224 Days and 0.4 Hours
Abstract

Splenic hamartoma (SH) is a rare benign tumor usually detected accidentally, which is composed of an aberrant mixture of normal splenic elements. Here, we report a case of 54-year-old man who presented with symptomatic multinodular SH and was admitted initially for thrombocytopenia and anemia. Physical examination revealed that the patients had an anemic appearance and palpable spleen, extending 10 cm below the costal margin. Preoperative ultrasound and computed tomography (CT) indicated splenomegaly with multinodular lesions. On enhanced CT scanning, during the arterial phase, the lesions demonstrated inhomogeneous enhancement, and in the portal phase the lesions were more hyperdense than the splenic parenchyma. The images were highly suggestive of a metastatic tumor. Splenectomy was performed 1 wk later. The tumor was eventually diagnosed as SH according to the morphological features and immunohistochemical detection, by which CD34 was positive in lining cells and some spindle cells, vimentin was positive in the tumor, factor-VIII-related antigen was positive multifocally in lining cells, and smooth muscle actin was positive in some spindle cells. Thrombocytopenia and anemia were cured after splenectomy.

Keywords: Splenic; Hamartoma; Splenectomy; Diagnosis; Symptoms

Core tip: Splenic hamartoma (SH) is a rare benign tumor that is usually detected accidentally. This case represents one of the largest SHs reported in the literature, and we report the use of immunohistochemistry as a tool to confirm the diagnosis. Thrombocytopenia and anemia were cured after splenectomy.