A fifty-seven-year-old female was admitted with chief complaints of purpura, a left hypochondrial mass and thrombocytopenia of 19,000/μl. 111In-labeled platelet scintigraphy demonstrated a shorened platelet life span and accumulation of radioisotope in the tumor.
Heparin administration did not influence the platelet counts which increased from 10,000 to 100,000 following prednisolone administration for twelve days, when a level of PAIgG was high. After extirpation of the tumor the platelet count increased to over 400,000 with normalization of the PAIgG level and shortened platelet life span. Pathological diagnosis of the resected tumor was teratoma of the spleen characterized by many microthrombi and foam cells in the sinus and arteriole of the spleen.
Thrombocytopenia associated with hamartoma of the spleen is very rare and only eleven cases have hitherto been reported. As to the mechanism of thrombocytpenia, immunological destruction was speculated although local consumption by thrombus formation and/or increased platelet pooling could not be ruled out completely.
This is the first case report of an effective prednisolone administration in this disease. Prednisolone might prove effective in a similar disease and tumorectomy may be carried out without a bleeding risk.
