Angioma esplénico de células litorales / Littoral cell angioma of the spleen

RESUMEN Presentamos el caso de un paciente varón de 62 años con masa dolorosa en hipocondrio izquierdo catalogado inicialmente como sarcoma irresecable, recibió quimioterapia y radioterapia sin respuesta, motivo por el cual se reintervino quirúrgicamente hallándose un tumor dependiente de bazo heterogéneo con perfil inmunohistoquímico de angioma de células litorales. El angioma de células litorales (ACL) es una lesión esplénica poco frecuente que se presenta asociado a síntomas genéricos como astenia, dolor regional y baja de peso, que requiere como manejo principal un abordaje quirúrgico. Suele ser una neoplasia asintomática de hallazgo incidental, afecta a ambos sexos por igual, cuyo diagnóstico es básicamente histológico e inmunohistoquímico con buen pronóstico luego de un abordaje quirúrgico inicial.

ABSTRACT A 62-year-old man with a medical history of a painful abdominal mass in left upper quadrant and general symptoms, who was classified initially as an unresectable sarcoma. He received chemotherapy and radiotherapy with no response, so he underwent a new surgery, finding a heterogeneous tumor with immunohistochemical consistent with littoral cell angioma. Littoral cell angioma (LCA) is a rare splenic lesion that presents general symptoms, so there are not many reports, which requires surgical management. Is usually an asymptomatic neoplasm of incidental finding, affecting both sexes equally, whose diagnosis is histological and immunohistochemical with a good prognosis always after a surgical approach.

Diagnosis and treatment of primary splenic tumor: an analysis of 63 cases / 中华肝胆外科杂志

Objective To summarize the experience in diagnosis and treatment of primary splenic neoplasm (PSN) to promote understanding of the disease. Methods The clinical data of all admitted patients with PSN treated in this hospital from February 1989 to February 2004 were retrospectively analyzed. Results A total of 63 patients were treated by surgery and pathologically confirmed as PSN. Twenty-one patients were treated by splenectomy alone. Twenty-seven patients underwent distal pancreatectomy and splenectomy. Fifteen patients received splenectomy combined with excision of tumor, the 5-year survival rate was 35.9%(15/42). Conclusion PSN should be diagnosed mainly according to clinical manifestations, image examination, and fine needle aspiration biopsy. CT and angiography play an important role in the identification of benign and malignant splenic mass. Early diagnosis, radical resection and comprehensive treatment are important for improving the prognosis of PSN.

Synchronous Isolated Splenic Metastasis from Colon Cancer

Isolated splenic metastases from colon cancer has been rarely reported in English literatures. Furthermore synchronous isolated splenic metastasis is very rare. We report a 63-year-old man with synchronous isolated splenic meta-stasis from colon cancer. He was suspicious to ascending colon cancer with isolated splenic metastasis by colono-fiberoscope, abdominal CT, fusion PET scan and elevated CEA level. He underwent right hemicolectomy and splenectomy. Histologic examinations revealed colonic adeno-carcinoma with splenic metastasis. He was discharged uneventfully and was planned to take chemotherapy. Although it appears to be rare, splenic mass with colon cancer patient should be evaluated to rule out metastasis and splenectomy for isolated splenic metastasis from colon cancer is warranted.

Clinical diagnosis and treatment of primary splenic tumor / 中华肝胆外科杂志

Objective To summarize the experience in diagnosis and treatment of primary splenic neoplasm (PSN). Methods The clinical data of 31 patients with PSN treated in our hospital were retrospectively analyzed. Results Amongst the patients, 25 were diagnosed as PSN postoperatively. Fifteen out of the 19 patients with benignancy were treated with splenectomy, and the others underwent partial splenectomy or tumor excision. Eleven out of the 12 patients with malignancy received splenectomy (including two by excision of pancreatic body and tail), and the other one underwent biopsy alone. The pathological types were as follows: varieties of cyst in 11, angiocavemoma in 4, inflammatory pseudotumor in 2, cavernous lymphangioma in 1, cystic degeratin of liomyoma in 1, malignant lymphoma and lymphsarcoma in 6, hemangiosarcoma in 3, fibrosarcoma in 1, liomyosarcoma in 1 and malignant fibrous histiocytoma in 1. Three patients with malignancy survived for 5 years. The reason was that they received radical splenectomy in combination with chemotherapy or radiotherapy and immunotherapy. Conclusions PSN should be diagnosed mainly according to clinical manifestations and image examination. The differentiation between benignancy and malignancy depends on CT, hemangiography and determination of seros AKP and ? GT levels. Early diagnosis, radical operation and comprehensive treatment are important for improving the prognosis of PSN.

The clinical analysis of 13 children with primary splenic tumor / 临床外科杂志

Objective To discuss the clinical characteristics and treatment of children with primary splenic tumor.Method A retrospective analysis was made on 13 children with primary splenic tumor from January 1970 to December 2001.Results There were splenic hemangioma in 5,splenic lymphoma in 4,splenic cysts in 2 and splenic malignant lymphoma in 2.In the primary splenic benign tumors,4 cases were treated with splenectomy,7 cases were treated with partily splenectomy;2 cases of splenectomy often had respiratory tract infection 1 year postoperatively.2 of the splenic malignant lymphoma were treated with splenectomy and chemotheraphy postoperatively;1 of them died 23 months postoperatively,another is still alive 8 months postoperatively.Conclusions The diagnosis of primary splenic tumor in children is mainly depended on B-ultrasound examination and CT scanning.Children with primary splenic benign tumors should be retained normal spleen as far as possible intraoperatively.It is important for splenectomy to pay more attention to the clinical infection 2 years postoperatively.Splenectomy combined with chemotherapy may provide optimum therapy for children with primary splenic malignant lymphoma.Early detection and treatment are crucial to increase the survival rate of children with primary splenic malignant lymphoma.