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Published in: Indian Journal of Surgery 4/2018

01-08-2018 | Original Article

Management of Incidentally Diagnosed Splenic Masses

Authors: Ulvi Murat Yuksel, Sevim Turanli, Ali Ugur Berberoglu, Kaptan Gulben

Published in: Indian Journal of Surgery | Issue 4/2018

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Abstract

The aim of this study is to consider the management of incidentally diagnosed splenic masses. Patients who underwent splenectomy between September 2005 and February 2015 were analyzed retrospectively. Patients with the history of lymphoproliferative disease were excluded. Radiologic evaluation was done in all patients. Preoperative tru-cut biopsies were performed on three patients. The patients were grouped according to the nature of the splenic mass such as cystic, benign, and malign lesions. The groups were compared according to age, gender, tumor size, and the number of lesions. There were 13 male and 12 female patients with the median age of 52 years (range 15–84 years). The final pathology revealed cyst in 7 patients (28.0%), benign lesion in 7 patients (28.0%), and malign lesion in 11 patients (44%). The results of tru-cut biopsies were similar with postoperative pathologies. Solitary lesions were detected in 15 patients, and there were multiple lesions in 10 cases. There was not a significant difference between the tumor sizes of malign vs. benign lesions (p = 0.42). Malignancy was a higher trend in multiple lesions (p = 0.06). Advanced radiologic imaging studies and more frequent and reliable use of percutaneous diagnostic procedures may limit the number of unnecessary splenectomies especially for benign lesions.
Literature
1.
go back to reference Gaetke-Udager K, Wasnik AP, Kaza RK et al (2014) Multimodality imaging of splenic lesions and the role of non-vascular, image-guided intervention. Abdom Imaging 39:570–587CrossRefPubMed Gaetke-Udager K, Wasnik AP, Kaza RK et al (2014) Multimodality imaging of splenic lesions and the role of non-vascular, image-guided intervention. Abdom Imaging 39:570–587CrossRefPubMed
2.
go back to reference Friedlander MA, Wei XJ, Iyengar P et al (2008) Diagnostic pitfalls in fine needle aspiration biopsy of the spleen. Diagn Cytopathol 36:69–75CrossRefPubMed Friedlander MA, Wei XJ, Iyengar P et al (2008) Diagnostic pitfalls in fine needle aspiration biopsy of the spleen. Diagn Cytopathol 36:69–75CrossRefPubMed
3.
go back to reference Falk S, Krishnan J, Meis JM (1993) Primary angiosarcoma of the spleen. A clinicopathologic study of 40 cases. Am J Surg Pathol 17:959–970CrossRefPubMed Falk S, Krishnan J, Meis JM (1993) Primary angiosarcoma of the spleen. A clinicopathologic study of 40 cases. Am J Surg Pathol 17:959–970CrossRefPubMed
5.
go back to reference Lam KY, Tang V (2000) Metastatic tumors to the spleen: a 25-year clinicopathologic study. Arch Pathol Lab Med 124:526–530PubMed Lam KY, Tang V (2000) Metastatic tumors to the spleen: a 25-year clinicopathologic study. Arch Pathol Lab Med 124:526–530PubMed
6.
go back to reference Schon CA, Gorg C, Ramaswamy A et al (2006) Splenic metastases in a large unselected autopsy series. Pathol Res Pract 202:351–356CrossRefPubMed Schon CA, Gorg C, Ramaswamy A et al (2006) Splenic metastases in a large unselected autopsy series. Pathol Res Pract 202:351–356CrossRefPubMed
7.
go back to reference Fowler RH (1953) Cystic tumours of the spleen. Int Abstr Surg 96:209–227PubMed Fowler RH (1953) Cystic tumours of the spleen. Int Abstr Surg 96:209–227PubMed
8.
go back to reference Morgenstern L (2002) Nonparasitic splenic cysts: pathogenesis, classification, and treatment. J Am Coll Surg 194:306–314CrossRefPubMed Morgenstern L (2002) Nonparasitic splenic cysts: pathogenesis, classification, and treatment. J Am Coll Surg 194:306–314CrossRefPubMed
9.
go back to reference Gianom D, Wildisen A, Hotz T et al (2003) Open and laparoscopic treatment of nonparasitic splenic cysts. Dig Surg 20:74–78CrossRefPubMed Gianom D, Wildisen A, Hotz T et al (2003) Open and laparoscopic treatment of nonparasitic splenic cysts. Dig Surg 20:74–78CrossRefPubMed
10.
go back to reference Thipphavong S, Duigenan S, Schindera ST et al (2014) Nonneoplastic, benign, and malignant splenic diseases: cross-sectional imaging findings and rare disease entities. AJR Am J Roentgenol 203:315–322CrossRefPubMed Thipphavong S, Duigenan S, Schindera ST et al (2014) Nonneoplastic, benign, and malignant splenic diseases: cross-sectional imaging findings and rare disease entities. AJR Am J Roentgenol 203:315–322CrossRefPubMed
11.
go back to reference Gómez-Rubio M, López-Cano A, Rendón P et al (2009) Safety and diagnostic accuracy of percutaneous ultrasound-guided biopsy of the spleen: a multicenter study. J Clin Ultrasound 37:445–450CrossRefPubMed Gómez-Rubio M, López-Cano A, Rendón P et al (2009) Safety and diagnostic accuracy of percutaneous ultrasound-guided biopsy of the spleen: a multicenter study. J Clin Ultrasound 37:445–450CrossRefPubMed
12.
go back to reference Handa U, Tiwari A, Singhal N et al (2013) Utility of ultrasound-guided fine-needle aspiration in splenic lesions. Diagn Cytopathol 41:1038–1042CrossRefPubMed Handa U, Tiwari A, Singhal N et al (2013) Utility of ultrasound-guided fine-needle aspiration in splenic lesions. Diagn Cytopathol 41:1038–1042CrossRefPubMed
13.
go back to reference Cuervo JL, Buela E (2007) Splenic epidermoid cyst: laparoscopic partial decapsulation. Circ Pediatr 20:63–67 Cuervo JL, Buela E (2007) Splenic epidermoid cyst: laparoscopic partial decapsulation. Circ Pediatr 20:63–67
14.
go back to reference Szczepanik AB, Meissner AJ (2009) Partial splenectomy in the management of nonparasitic splenic cysts. World J Surg 33:852–856CrossRefPubMed Szczepanik AB, Meissner AJ (2009) Partial splenectomy in the management of nonparasitic splenic cysts. World J Surg 33:852–856CrossRefPubMed
15.
go back to reference Gochhait D, Dey P, Rajwanshi A et al (2015) Role of fine needle aspiration cytology of spleen. APMIS 123:190–193CrossRefPubMed Gochhait D, Dey P, Rajwanshi A et al (2015) Role of fine needle aspiration cytology of spleen. APMIS 123:190–193CrossRefPubMed
17.
go back to reference Ruiz-Fernandez M, Guerra-Vales MJ, Enguita-Valls A et al (2008) Splenic hydatid cyst, a rare location of extrahepatic echinococcosis: report of six cases. European Journal of Internal Medicine 19:51–53CrossRef Ruiz-Fernandez M, Guerra-Vales MJ, Enguita-Valls A et al (2008) Splenic hydatid cyst, a rare location of extrahepatic echinococcosis: report of six cases. European Journal of Internal Medicine 19:51–53CrossRef
18.
go back to reference Moir C, Guttman F, Jequier S et al (1989) Splenic cysts: aspiration, sclerosis, or resection. J Pediatr Surg 24:646–648CrossRefPubMed Moir C, Guttman F, Jequier S et al (1989) Splenic cysts: aspiration, sclerosis, or resection. J Pediatr Surg 24:646–648CrossRefPubMed
19.
go back to reference Goktay AY, Secil M, Ozcan MA et al (2006) Percutaneous treatment of congenital splenic cysts: drainage and sclerotherapy with polidocanol. Cardiovasc Intervent Radiol 29:469–472CrossRefPubMed Goktay AY, Secil M, Ozcan MA et al (2006) Percutaneous treatment of congenital splenic cysts: drainage and sclerotherapy with polidocanol. Cardiovasc Intervent Radiol 29:469–472CrossRefPubMed
20.
go back to reference Kamaya A, Weinstein S, Desser TS (2006) Multiple lesions of the spleen: differential diagnosis of cystic and solid lesions. Semin Ultrasound CT MR 27:389–403CrossRefPubMed Kamaya A, Weinstein S, Desser TS (2006) Multiple lesions of the spleen: differential diagnosis of cystic and solid lesions. Semin Ultrasound CT MR 27:389–403CrossRefPubMed
21.
go back to reference Abbott RM, Levy AD, Aguilera NS et al (2004) From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics 24:1137–1163CrossRefPubMed Abbott RM, Levy AD, Aguilera NS et al (2004) From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics 24:1137–1163CrossRefPubMed
23.
go back to reference Kakisaka T, Kamiyama T, Yokoo H et al (2014) Hand-assisted laparoscopic splenectomy for sclerosing angiomatoid nodular transformation of the spleen complicated by chronic disseminated intravascular coagulation: a case report. Asian J Endosc Surg 7:275–278CrossRefPubMed Kakisaka T, Kamiyama T, Yokoo H et al (2014) Hand-assisted laparoscopic splenectomy for sclerosing angiomatoid nodular transformation of the spleen complicated by chronic disseminated intravascular coagulation: a case report. Asian J Endosc Surg 7:275–278CrossRefPubMed
Metadata
Title
Management of Incidentally Diagnosed Splenic Masses
Authors
Ulvi Murat Yuksel
Sevim Turanli
Ali Ugur Berberoglu
Kaptan Gulben
Publication date
01-08-2018
Publisher
Springer India
Published in
Indian Journal of Surgery / Issue 4/2018
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-016-1582-y

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