罕見瀰漫性脾臟海綿血管瘤：一病例報告

脾臟海綿血管瘤(cavernous hemangioma of spleen)是很少見的，也很不容易在手術前獲得正確的診斷。瀰漫性的脾臟海綿血管瘤可能造成脾臟腫大(splenomegaly)、高門脈壓(portal hypertension)、脾機能過盛(hypersplenism)、血栓(thrombosis)、血管梗塞(infarction)或感染而形成膿瘍(abscess)。甚而在四分之一的瀰漫性脾臟海綿血管瘤併有脾臟腫大的病人可能發生脾臟破裂的致命併發症。我們報告一名五十歲女性病患，無意間在腹部超音波中發現多個位於脾臟的腫瘤。在以往的文獻中，不論是超音波(sonography)、電腦斷層(computed tomography)或是磁共振照影(MRI)都無法在影像學檢查中提供正確的診斷。另外，侵入性檢查如血管攝影(angiography)及細針穿刺抽吸(fine-needle aspiration)則因其診斷率和併發症的考量，也都不是理想的診斷方法。為了避免可能的嚴重併發症如脾臟破和惡性轉變(malignant transformation)，病患接受了開腹脾臟摘除術，術後及門診追蹤半年情況良好。

關鍵字

脾臟腫瘤；海綿血管瘤

並列摘要

Diffuse cavernous hemangioma of the spleen is a rare condition and difficult to be diagnosed preoperatively. Splenic cavernous hemangioma may cause some complication, such as splenomegaly, portal hypertension, hyperesplenism, thrombosis, infarction and infection with abscess. Furthermore, a potential lethal complication, rupture of spleen, may happen in 25% of patients with diffuse cavernous hemangioma and splenomegaly. A 50 years old woman with asymptomatic diffuse splenic tumors was discovered accidentally by abdominal sonography. In reviewed articles, computed tomography, sonography and MRI were elusive for diagnosis because of misleading patterns on imaging. Invasive diagnostic methods like angiography and fine needle aspiration offer few information for diagnosis, but the complications of them may be considered. Splenectomy was performed in order to exclude malignancy and prevent serious complications, splenic rapture and malignant transformation. She was uneventfully discharged and followed.

並列關鍵字

Splenic neoplasm ； Cavernous hemangioma

國際替代計量

罕見瀰漫性脾臟海綿血管瘤：一病例報告

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