Splenic lymphangioma masquerading as splenic abscess managed by laparoscopic splenectomy: A case report

BACKGROUND: Primary benign splenic tumours are unique and account for < 0.007% of all tumours identified during surgery and autopsy. Splenic lymphangiomas are rarely seen in adults. Splenic lymphangiomas may be asymptomatic, or may present with upper left abdominal pain, splenomegaly, hypersplenism, or splenic rupture with haemorrhagic shock. The clinical and radiological features of these lesions are not specific. This case report serves to remind the clinician to consider the rare but important differential diagnosis of splenic lymphangioma while treating splenic lesions. CASE SUMMARY: We report a case of splenic lymphangioma in a 22-year-old woman who presented with left upper quadrant abdominal pain for three months. Initial investigations were unremarkable; however, computed tomography later revealed multiple splenic micro-abscesses. The patient underwent laparoscopic splenectomy, and histopathological examination revealed splenic lymphangioma. The patient was discharged on postoperative day three. One month after surgery, the abdominal pain resolved completely, with no new complaints. Splenic lymphangiomas present clinically as splenomegaly or left upper quadrant abdominal pain; prompt intervention is necessary for avoiding complications. CONCLUSION: This case report concludes that splenic lymphangiomas should be considered in the differential diagnosis of splenomegaly or left upper quadrant pain, even in adults, because they are amenable to curative treatment. Delays in surgical intervention may lead to severe complications, such as infection, rupture, and hemorrhage. Such lesions can be safely managed with laparoscopy, involving less postoperative pain and early patient discharge with excellent cosmetic outcomes.