title: Laparoscopic splenectomy for histiocytic sarcoma of the spleen.
abstract: 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 post-operative 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.
authors.affiliation: Satoshi Yamamoto, Tadashi Tsukamoto, Akishige Kanazawa, Sadatoshi Shimizu, Keiichiro Morimura, Takahiro Toyokawa, Zhang Xiang, Katsunobu Sakurai, Tatsunari Fukuoka, Kayo Yoshida, Mamiko Takii, Department of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka 534-0021, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Akishige
authors.initials: A
authors.lastname: Kanazawa
authors.forename: Sadatoshi
authors.initials: S
authors.lastname: Shimizu
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Morimura
authors.forename: Takahiro
authors.initials: T
authors.lastname: Toyokawa
authors.forename: Zhang
authors.initials: Z
authors.lastname: Xiang
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Sakurai
authors.forename: Tatsunari
authors.initials: T
authors.lastname: Fukuoka
authors.forename: Kayo
authors.initials: K
authors.lastname: Yoshida
authors.forename: Mamiko
authors.initials: M
authors.lastname: Takii
authors.forename: Ken
authors.initials: K
authors.lastname: Inoue
keywords: Chemotherapy; Histiocytic sarcoma; Laparoscopic splenectomy; Malignancy; Splenomegaly