A Case of Splenic Cord Capillary Hemangioma Treated with Partial Splenectomy

Abstract

A 12-year-old boy was referred to our hospital with suspected lymphoma when a splenic tumor was detected incidentally on a computed tomography (CT) scan following a fall. Magnetic resonance imaging (MRI) showed a round mass, 5 cm × 4.5 cm × 4.5 cm in size, in the splenic hilum that was hypointense on T1-weighted and hyperintense on T2-weighted imaging. On contrast-enhanced MRI, the mass was strongly enhanced almost homogeneously from the early phase, and the contrast effect was prolonged. A preoperative diagnosis of hemangioma or vascular tumor was made, and laparotomic partial splenectomy was performed. Doppler echocardiography was used to confirm the presence of blood flow between the tumor and healthy tissue, and peripheral branches of the splenic artery were sequentially clamped to identify the vessels feeding the tumor. Indigo carmine was injected via the tumor feeding vessels, and the incision line was determined so as to minimize hemorrhage during the partial resection. The remaining spleen was fixed to the greater omentum to prevent torsion. The patient's postoperative course was uneventful, and he was discharged from hospital five days postoperatively. The pathological diagnosis was cord capillary hemangioma.