A giant splenic hamartoma associated with hematologic disorders: A case report.

Introduction: Splenic hamartoma is a primary benign tumor of the spleen, with approximately 150 cases documented in the literature to date, with only a few cases associated with symptoms and hematologic disorders.
Presentation of Case: A 49-year-old female with no past medical history, presented to the emergency department complaining of a three-month history of intermittent abdominal pain and 12 kg of weight loss. Physical examination revealed abdominal distension and a big palpable and painless mass on the left side of her abdomen measuring 14 cm. Laboratory tests were significant for anemia and thrombocytopenia, with levels of 9.7 g/dL and 47 × 10 ⁹ /L respectively. Ultrasonography showed splenomegaly with a hypoechoic splenic mass and the computed tomography showed a 14 cm splenic mass with heterogeneous enhancement during the arterial phase. A laparotomy with splenectomy was unremarkably accomplished. Histological examination revealed abnormal red pulp proliferation and showed unorganized sinusoid-like vascular channels, compatible with splenic hamartoma. The patient was discharged on postoperative day 3 without complications. She was seen at the ambulatory clinic 6-months after the surgical procedure with a normal blood count.
Discussion: Although splenic hamartoma is very rare, it must be included in the differential diagnosis of splenic mass-forming lesions. This type of tumor has some specific radiological features. However, the diagnosis of this disease must be based on clinical features and confirmed by pathology.
Conclusion: In patients with splenic tumors, splenectomy is indicated in cases where malignancy cannot be excluded, when symptoms occur, or in the rare cases of consequent hematologic disorders.