[Hamartoma of the spleen]

Hamartoma is a rare benign lesion of the spleen. Between 140 and 150 cases seem to have been described so far. Hamartoma of the spleen may appear as a single or multiple lesions which may tend to converge. It appears in all ages, mainly in elderly persons. About 20% of patients were described in paediatric subjects. Half of the patients have no symptoms, so that hamartomas were discovered by chance at autopsy. Other 50% of patients had pain, splenomegaly, haematologic abnormalities (most frequently thrombocytopenia or pancytopenia) and spontaneous rupture with intra-abdominal bleeding. In children, hamartoma of the spleen with haematologic abnormalities may be followed by growth retardation, frequent infections, fever and night sweating. The bigger the hamartoma the greater probability to cause symptoms. The exact preoperative diagnosis is rarely established. Hamartoma has to be taken into account always when tumour of the spleen is diagnosed, particularly in children. Splenectomy is the most frequent treatment of symptomatic hamartoma of the spleen. Partial splenic resection is the preferred surgery whenever it may be carried out, particularly in children. We report a 58 year old woman with a five-year history of left subcostal and lumbar pain in whom in the lower pole of moderately enlarged spleen a tumorous mass, 107 x 75 mm in diameter, was discovered on ultrasonography. She was submitted to splenectomy as well as to cholecystectomy due to gall bladder stones. Histological findings of the spleen showed hamartoma. She had an uneventful recovery. The pain disappeared after surgery. She stayed symptom free so far.