Case Report
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World J Gastrointest Surg. Apr 27, 2010; 2(4): 147-152
Published online Apr 27, 2010. doi: 10.4240/wjgs.v2.i4.147
Laparoscopic splenectomy for splenic hamartoma: Case management and clinical consequences
Tsutomu Namikawa, Hiroyuki Kitagawa, Jun Iwabu, Michiya Kobayashi, Manabu Matsumoto, Kazuhiro Hanazaki
Tsutomu Namikawa, Hiroyuki Kitagawa, Jun Iwabu, Kazuhiro Hanazaki, Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi 783-8505, Japan
Michiya Kobayashi, Department of Human Health and Medical Sciences, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi 783-8505, Japan
Manabu Matsumoto, Laboratory of Diagnostic Pathology, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi 783-8505, Japan
Author contributions: Namikawa T and Hanazaki K contributed equally to this work; Namikawa T, Kitagawa H, Iwabu J and Kobayashi M designed the research and performed the research; Namikawa T and Matsumoto M contributed new reagents/analytic tools; Namikawa T and Hanazaki K analyzed the data and wrote the paper.
Correspondence to: Tsutomu Namikawa, PhD, Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi 783-8505, Japan. tsutomun@kochi-u.ac.jp
Telephone: +81-88-8802370 Fax: +81-88-8802371
Received: November 13, 2009
Revised: January 11, 2010
Accepted: January 18, 2010
Published online: April 27, 2010
Abstract

Splenic hamartoma is a rare benign tumor, and although minimally invasive surgery may be suitable for this condition, there have only been 2 previous reports of laparoscopic surgery. Here we report the third case of splenic hamartoma managed by laparoscopic splenectomy. A 37-year-old male was incidentally diagnosed by abdominal ultrasonography with a hypoechoic mass measuring 2.5 cm × 2.4 cm in the spleen. Color Doppler sonography showed multiple flow signals within the mass and contrast-enhanced computed tomography revealed strong enhancement of the lesion. On T1- and T2-weighted magnetic resonance images, the splenic mass was demonstrated as isointense and hyperintense respectively. Although a malignant tumor could not be ruled out, a hand-assisted laparoscopic splenectomy was performed because the splenic mass was limited in size and had not invaded adjacent organs. The pathological diagnosis was splenic hamartoma. The postoperative course was uneventful and the patient was discharged by the seventh postoperative day. Although splenic hamartomas have some specific imaging features, more reports and analyses of these cases are required to increase the reliability of the diagnosis and management. Hand-assisted laparoscopic splenectomy may play a pivotal role in the postoperative diagnosis and management of this condition.

Keywords: Splenic hamartoma, Splenoma, Splenic tumor, Laparoscopic splenectomy, Splenectomy