Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2023; 14(10): 440-444
Published online Oct 24, 2023. doi: 10.5306/wjco.v14.i10.440
Splenic lymphangioma masquerading as splenic abscess managed by laparoscopic splenectomy: A case report
Santosh Thorat, Febin Mohammed Shaji
Santosh Thorat, Febin Mohammed Shaji, Department of General Surgery, Pimpri Chinchwad Municipal Corporation's Postgraduate Institute and Yashwantrao Chavan Memorial Hospital, Pune 411018, Maharashtra, India
Author contributions: Thorat S performed the surgery and was the chief consultant surgeon; Shaji FM assisted the case and compiled the information and created the manuscript.
Informed consent statement: The study participant, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No conflicts of interest declared.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Febin Mohammed Shaji, MBBS, Surgeon, Department of General Surgery, Pimpri Chinchwad Municipal Corporation's Postgraduate Institute and Yashwantrao Chavan Memorial Hospital, Sant Tukaram Nagar, Pimpri, Pune 411018, Maharashtra, India. febinmshaji@gmail.com
Received: May 26, 2023
Peer-review started: May 26, 2023
First decision: July 6, 2023
Revised: July 19, 2023
Accepted: September 19, 2023
Article in press: September 19, 2023
Published online: October 24, 2023
Processing time: 150 Days and 18.6 Hours
Abstract
BACKGROUND

Primary benign splenic tumours are unique and account for < 0.007% of all tumours identified during surgery and autopsy. Splenic lymphangiomas are rarely seen in adults. Splenic lymphangiomas may be asymptomatic, or may present with upper left abdominal pain, splenomegaly, hypersplenism, or splenic rupture with haemorrhagic shock. The clinical and radiological features of these lesions are not specific. This case report serves to remind the clinician to consider the rare but important differential diagnosis of splenic lymphangioma while treating splenic lesions.

CASE SUMMARY

We report a case of splenic lymphangioma in a 22-year-old woman who presented with left upper quadrant abdominal pain for three months. Initial investigations were unremarkable; however, computed tomography later revealed multiple splenic micro-abscesses. The patient underwent laparoscopic splenectomy, and histopathological examination revealed splenic lymphangioma. The patient was discharged on postoperative day three. One month after surgery, the abdominal pain resolved completely, with no new complaints. Splenic lymphangiomas present clinically as splenomegaly or left upper quadrant abdominal pain; prompt intervention is necessary for avoiding complications.

CONCLUSION

This case report concludes that splenic lymphangiomas should be considered in the differential diagnosis of splenomegaly or left upper quadrant pain, even in adults, because they are amenable to curative treatment. Delays in surgical intervention may lead to severe complications, such as infection, rupture, and hemorrhage. Such lesions can be safely managed with laparoscopy, involving less postoperative pain and early patient discharge with excellent cosmetic outcomes.

Keywords: Spleen; Lymphangioma; Oncology; Rare; Laparoscopic splenectomy; Hamartomatous process; Case report

Core Tip: We present the rare case report of splenic lymphangioma in an adult female. This is a very rare entity with only around 200 cases reported between 1970 to 2017. Isolated splenic lymphangioma is very rare and should be considered in the differential diagnosis of splenomegaly, for early intervention and prevention of potential complications.