A Case of Splenic Hemangioma Associated with Kasabach-Merritt Syndrome

Atsushi Miyamoto, Masatomo Tada, Chikara Ebisui, Makoto Okazaki, Toshio Kanai, Atsuo Murata, Tsugukiyo Hirai, Nobuhiro Murai

The Department of Surgery, Hyogo Prefectural Nishinomiya Hospital

We report an extremely rare case of Kasabach-Merritt syndrome due to splenic hemangioma. The patient was a 68-year-old woman who was referred to our hospital for further evaluation of purpura in the extremities. The results of hematological analyses on admission showed severe thrombocytopenia. In addition, abdominal ultrasonography and computed tomography revealed a large splenic tumor. Abdominal magnetic resonance imaging demonstrated a tumor of heterogeneous intensity on a T2 weighted image and it was suspected that the low and high intensity corresponded to acellular areas of infarction and vascular pools respectively. Under a diagnosis of splenic hemangioma associated with Kasabach-Merritt syndrome, splenectomy was performed. The tumor was 5.5×4.0×3.6 cm in diameter, and histological study revealed a hemangioma with an intravascular thrombus. The number of platelets returned to the normal level immediately after surgery. It was suggested that magnetic resonance imaging is useful for diagnosis and that splenectomy is the best therapeutic option in a case of splenic hemangioma complicated with Kasabach-Merritt syndrome.

Key words
splenic hemangioma, thrombocytonia, Kasabach-Merritt Syndrome

Reprint requests
Atsushi Miyamoto Department of Surgery, Hyogo Prefectural Nishinomiya Hospital
13-9 Rokutanji-cho Nishinomiya, 662 JAPAN

Accepted
September 9, 1997

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