Giant cavernous haemangioma of the spleen presenting as massive splenomegaly and treated by partial splenectomy

Ghuliani D, Agarwal S, Thomas S, Pathania OP
Correspondence: Dr Shaji Thomas, drshajithomas@yahoo.com

ABSTRACT
Cavernous haemangioma is a rare disorder of the spleen with fewer than 100 cases reported. Only rarely do they attain large sizes. A 36-year-old woman presented with a six-month history of pain in the left hypochondrium and a massive splenomegaly. Ultrasonography, Doppler studies, and computed tomography could not distinguish between a haemangioma and a secondary deposit. Magnetic resonance imaging showed characteristic features of splenic haemangioma with central fibrosis, thrombosis and haemorrhage. Partial splenectomy was done. Intraoperative imprint cytology was negative for malignant cells. Histopathology showed cavernous haemangioma with areas of infarction necrosis. It is extremely rare to have such a massive solitary splenic haemangioma presenting as a giant splenomegaly. Preoperative investigations are often inconclusive and may not distinguish between haemangioma and metastases. Magnetic resonance imaging is the most reliable imaging method. Haemangiomas are treated only when they are symptomatic or very large with an increased risk of haemorrhage. Partial splenectomy is the treatment of choice.

Keywords: cavernous haemangioma of spleen, giant splenomegaly, haemangioma, partial splenectomy, splenic haemangioma
Singapore Med J 2008; 49(12): e356-e358