Laparoscopic splenectomy for histiocytic sarcoma of the spleen  

作　　者：Satoshi Yamamoto Tadashi Tsukamoto Akishige Kanazawa Sadatoshi Shimizu Keiichiro Morimura Takahiro Toyokawa Zhang Xiang Katsunobu Sakurai Tatsunari Fukuoka Kayo Yoshida Mamiko Takii Ken Inoue 

机构地区：[1]Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital [2]Division of Surgery, Department of Hepatobiliary Pancreatic Surgery and Artificial Organ and Transplantation, Graduate School of Medicine, the University of Tokyo [3]Department of Pathology, Osaka City General Medical Hospital

出　　处：《World Journal of Gastrointestinal Surgery》2013年第4期129-134,共6页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Primary histiocytic sarcoma of the spleen is a rare but potentially lethal condition. It can remain asymptomatic or only mildly symptomatic for a long time. An 81-year-old woman presented with an extremely enlarged spleen. She suffered from progressive anemia and required a red blood cell transfusion once a month. Although computed tomography, ultrasonography, and magnetic resonance imaging were performed for diagnosis, a confirmed diagnosis was not obtained. Her enlarged spleen compressed her stomach, and she suffered from gastritis and a sense of gastric fullness just after meals. She underwent laparoscopic splenectomy for therapeutic and diagnostic purposes. Her postoperative course was uneventful. After surgery, her red blood cell and platelet counts increased markedly. The tumor was diagnosed as splenic histiocytic sarcoma. Post-surgical chemotherapy was not performed, and the patient died of liver failure due to liver metastasis 5 mo after surgery. Laparoscopic splenectomy is minimally invasive and useful for the relief of symptoms related to hematological disorders. However, in cases of an enlarged spleen, optimal views and working space are limited. In such cases, splenic artery ligation can markedly reduce the size of the spleen, thus facilitating the procedure. The case reported herein suggests that laparoscopic splenectomy may be useful for the treatment of splenic malignancy.Primary histiocytic sarcoma of the spleen is a rare but potentially lethal condition. It can remain asymptomatic or only mildly symptomatic for a long time. An 81-year-old woman presented with an extremely enlarged spleen. She suffered from progressive anemia and required a red blood cell transfusion once a month. Although computed tomography, ultrasonography, and magnetic resonance imaging were performed for diagnosis, a confirmed diagnosis was not obtained. Her enlarged spleen compressed her stomach, and she suffered from gastritis and a sense of gastric fullness just after meals. She underwent laparoscopic splenectomy for therapeutic and diagnostic purposes. Her postoperative course was uneventful. After surgery, her red blood cell and platelet counts increased markedly. The tumor was diagnosed as splenic histiocytic sarcoma. Post-surgical chemotherapy was not performed, and the patient died of liver failure due to liver metastasis 5 mo after surgery. Laparoscopic splenectomy is minimally invasive and useful for the relief of symptoms related to hematological disorders. However, in cases of an enlarged spleen, optimal views and working space are limited. In such cases, splenic artery ligation can markedly reduce the size of the spleen, thus facilitating the procedure. The case reported herein suggests that laparoscopic splenectomy may be useful for the treatment of splenic malignancy.

关 键 词：Histiocytic SARCOMA LAPAROSCOPIC SPLENECTOMY MALIGNANCY SPLENOMEGALY Chemotherapy 

分 类 号：R735.9[医药卫生—肿瘤]