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We report a rare finding of the coexistence of splenic hemangioma and progressive vascular malformation of the left lower extremity in a child. The lesion on the left calf was described as a vascular malformation in computed tomography and magnetic resonance. At the age of one year, the abdominal Doppler ultrasound was normal. The examination was repeated at the age of six years due to recurrent pain in the left hypochondrium and revealed giant multiple splenic hemangiomas. The girl underwent splenectomy at the age of 14 years. Histological findings demonstrated multiple cavernous hemangiomas. We present our case report regarding the diagnosis of spleen hemangioma and indications for surgical management in children. [ABSTRACT FROM AUTHOR]

Splenic tumors are rare and are sometimes found incidentally. In such cases, laboratory tests and imaging studies should be performed based on the diagnostic algorithm to determine whether the tumor is benign or malignant. However, we clinicians sometimes encounter challenging cases. Herein we experienced two challenging cases of splenic tumor which we could not correctly diagnosis preoperatively. Case 1: A female in her 80s presented to our surgical department to undergo follow-up examinations for Stage IIIa ascending colon cancer. A follow-up CT scan showed marked enlargement of the splenic tumor which suggested metastatic cancer. We performed laparoscopic splenectomy. Case 2: A healthy female in her 50s presented to our internal medicine department to undergo a workup after multiple splenic tumors. A follow-up CT scan showed that the tumors had grown slightly. We could not completely rule out a malignant tumor. She rejected further follow-up study and chose splenectomy. We experienced two cases of splenic hemangioma with different clinical presentations and imaging findings. Although some studies have reported that biopsying a splenic tumor is a safe and effective way of distinguishing among splenic tumors, in our country splenic biopsies are seldom performed due to fears of causing intraabdominal bleeding or tumor dissemination. Clinicians should consider whether it would be better to perform follow up with a biopsy or splenectomy as a definitive treatment on a case-by-case basis. Laparoscopic splenectomy can be used for definitive management in cases involving malignancy or an uncertain etiology. • Splenic tumors are sometimes challenging to be correctly diagnosed. • We should recognize a diagnostic algorithm, but not always applicable. • Clinicians should choose follow-up or splenectomy on a case-by-case basis. • Splenectomy is the definitive management of malignancy or an uncertain etiology. [ABSTRACT FROM AUTHOR]

We discuss current knowledge and management of splenic hamartoma, an uncommon form of benign tumor. A splenic hamartoma is a rare form of benign splenic mass, often found incidentally while working up other complaints, and is typically treated by surgical resection of the mass. In this case, we discuss the management of an incidentally found splenic hamartoma that was treated with laparoscopic partial splenectomy. The patient presented in the Emergency Department complaining of periumbilical pain after having been struck in the abdomen with a soccer ball the previous day. Following a physical exam and blood work, an ultrasound was performed that revealed a hypoechoic area within the spleen. The patient received a diagnosis of gastroenteritis and an appointment for follow-up at 2 months. At 2-month follow-up, an ultrasound indicated that the mass had grown. The mass appeared consistent with a splenic hemangioma, so the patient was scheduled for laparoscopic partial splenectomy. The mass was completely resected without any complications. The patient had an uncomplicated postoperative course. When there are no other indications for a total splenectomy and malignancy is unlikely, laparoscopic partial splenectomy appears to be a reasonable treatment modality for a splenic hamartoma. [ABSTRACT FROM AUTHOR]