A Case Report of Giant Splenic Hamartoma Associated with Thrombocytopenia

Noriyuki Okada, Yasuhiro Ogura, Hiroyuki Kobayashi, Hiroaki Terajima, Michihiko Wada, Yoshikazu Masai, Tokiharu Miyahara, Takashi Hashimoto, Ryo Hosotani and Tatehiro Kajiwara

Department of Surgery, Kobe City General Hospital

We report a case of giant splenic hamartoma associated with thrombocytopenia. A 24-year-old man with general malaise was admitted to our hospital in March 2005 because of thrombocytopenia. Hematogenous cancer was ruled out by bone marrow biopsy, and a giant splenic tumor was found by abdominal CT. Ultrasonography revealed a heterogeneous tumor that occupied almost the entire spleen and blood-flow signals inside the tumor. Plain CT showed heterogeneous low density, whereas enhanced CT showed multiple mosaic-like low density spots in a high density area that appeared to be the parenchyma of the tumor. MRI showed spotted low intensity signals on the T1-weighted image and multiple high and low signal intensity nodules inside a high intensity area on the T2-weighted image. A diagnosis of splenic tumor with multiple thrombi was made, and we performed splenectomy. The resected specimen weighed 2,650 g and was almost completely occupied by tumor and organizing thrombus. The tumor measured 22×17×12 cm, and the pathological diagnosis was hamartoma of the red pulp type. We consider that this case is the maximum size of splenic hamartoma as long as we could examine in the previous literatures.

Key words
splenic hamartoma, thrombocytopenia, splenomegaly

Reprint requests
Noriyuki Okada Department of Surgery, Kobe City General Hospital
4-6 Minatojimanakamachi, Chuo-ku, Kobe, 650-0046 JAPAN

Accepted
March 22, 2006

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