Giant Splenic Hamartoma with Thrombocytopenia

Abstract

We report a case of giant splenic hamartoma combined with thrombocytopenia. The patient was a 39-year-old man in whom thrombocytopenia was detected during an annual health check, which resulted in him being referred to our hospital. Abdominal US revealed a 10-cm hypoechoic splenic tumor that displayed internal blood flow. Enhanced CT showed a relatively well-defined circular splenic mass. MRI showed that the splenic tumor exhibited the same intensity as the normal splenic parenchyma on T1-weighted images, and the same to high signal intensity on T2-weighted images. ¹⁸F-FDG-PET/CT revealed a quite strong FDG accumulation (SUVmax=3.0) in the splenic tumor. We performed splenectomy due to the possibility of a malignant tumor, thrombocytopenia related to splenic hyperactivity, and the risk of rupture. No infiltration into the surrounding splenic tissue was observed during an intraoperative examination. The tumor was pathologically diagnosed as a hamartoma since immunohistochemical staining showed that CD8+ cells and CD34+ cells were equally distributed throughout the tumor. The patient’s platelet count normalized after the operation.