Treatment of hemolymphangioma of the spleen by laparoscopic partial splenectomy: a case report
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CASE REPORT
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Treatment of hemolymphangioma of the spleen by laparoscopic partial splenectomy: a case report Yue Zhang, Xue-Min Chen*, Dong-Lin Sun and Chun Yang
Abstract Hemolymphangioma is a malformation of both lymphatic and blood vessels. The incidence of splenic hemolymphangioma is extremely rare. Laparoscopic partial splenectomy is feasible, reproducible, and safe in children with focal splenic tumors. We report on the case of a 12-year-old male with a large splenic hemolymphangioma successfully managed by laparoscopic partial splenectomy. The patient recovered well after operation. Laparoscopic partial splenectomy is a safe and minimally invasive technique for treatment of splenic hemolymphangioma located in the pole of the spleen.
Background Focal splenic tumors, including splenic cysts and vascular neoplasms, are uncommon and require complete resection to prevent complications or recurrence [1]. Hemolymphangioma is a malformation of both lymphatic and blood vessels. The incidence of splenic hemolymphangioma is extremely rare. In the past, total splenectomy has been the method of choice for the treatment of splenic tumors. Today, a spleen-preserving minimally invasive approach is being increasingly advocated, especially in children and young adults, in order to avoid overwhelming post-splenectomy infection [2,3]. With a better understanding of vascular anatomy and the development of fine laparoscopic skills, laparoscopic partial splenectomy became safe and feasible. In this paper, we report on a rare case of splenic hemolymphangioma successfully managed by laparoscopic partial splenectomy. Case presentation A 12-year-old male was admitted to our hospital with a complaint of abdominal pain for one month. There was no history of trauma, no weight loss, and no family history of cancer. A physical examination showed a tender left upper-quadrant abdominal mass. Laboratory tests, including serum tumor markers, were normal. Computed tomography confirmed a large 15.7 × 8.5 cm cyst * Correspondence: [email protected] Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
occupying the upper pole of the spleen (Figure 1) and demonstrated almost total displacement of the remaining splenic parenchyma (Figure 2). The patient underwent a laparoscopic partial splenectomy. In brief, the patient was induced under general anesthesia and placed in the supine position. Using Hasson’s technique, the pneumoperitoneum was achieved at a pressure of 8 mmHg and a flow rate of 1.5 L/min. A 10-mm port was placed sub-umbilically for laparoscopy. Four more ports were placed under vision: a 5-mm port in the subcostal border in the right mid-clavicular line, a 5-mm port under the costal border 6 cm in the right mid-clavicular line, a 5-mm port parallel to the umbilicus in the left anterior axillary line, and a 5-mm port parallel to the umbilicus in the left mid-clavicular line. A hilar dissection was carefully performed, and the supe
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