title: Multiple splenic hamartomas and familial adenomatous polyposis: a case report and review of the literature.
abstract: BACKGROUND
  Splenoma or splenic hamartoma is a rare primary splenic tumor most often discovered radiologically and incidentally. Splenic hamartomas have a strong association with solid and hematological malignancies and, in rare cases, with tuberous sclerosis, but to the best of our knowledge no reports of splenic hamartomas associated with familial adenomatous polyposis have been documented, although it is recognized that familial adenomatous polyposis presents a variety of extracolonic manifestations.
  
  
  METHODS
  We report on a very rare case of multiple splenic hamartomas in a 46-year-old white woman who had previously undergone surgery for restorative proctocolectomy for familial adenomatous polyposis. A computed tomography scan of her spleen revealed multiple small lesions which measured less than 1cm in diameter. A splenectomy was performed and a histologic examination of the splenectomy specimen revealed the presence of multiple hamartomas.
  
  
  CONCLUSIONS
  Incidence, differential diagnosis, diagnostic procedures, pathologic findings and treatment of splenic hamartomas are discussed here and hamartomas are considered in a differential diagnosis of splenic tumors. A splenectomy is indicated in cases where malignancy cannot be excluded and in cases of associated hematologic disorders. To the best of our knowledge our patient is the first reported case to have splenic hamartomas identified in a familial adenomatous polyposis-affected patient with mutation in exon 15 of the APC gene. At this time it is not possible to correlate with certainty our multiple splenic hamartomas and familial adenomatous polyposis case as a clinical manifestation of the mutation of APC gene; however, we believe that this case report could be important for further observation of similar cases in the future.
authors.affiliation: General Surgery Unit - Advanced Biomedical Science Department, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy. nicola.anita@tiscali.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Carlomagno
authors.affiliation: Molecular Medicine and Medical Biotechnology Department, University Federico II of Naples, Naples, Italy. duraturo@dbbm.unina.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Duraturo
authors.affiliation: General Surgery Unit - Advanced Biomedical Science Department, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy. mariacandida84@libero.it.
authors.forename: Maria
authors.initials: M
authors.lastname: Candida
authors.affiliation: Molecular Medicine and Medical Biotechnology Department, University Federico II of Naples, Naples, Italy. marina.derosa@unina.it.
authors.forename: Marina
authors.initials: M
authors.lastname: De Rosa
authors.affiliation: Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy. valeriavarone@gmail.com.
authors.forename: Valeria
authors.initials: V
authors.lastname: Varone
authors.affiliation: Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy. giuseppeciancia@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciancia
authors.affiliation: General Surgery Unit - Advanced Biomedical Science Department, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy. armcalo@libero.it.
authors.forename: Armando
authors.initials: A
authors.lastname: Calogero
authors.affiliation: General Surgery Unit - Advanced Biomedical Science Department, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy. misantan@unina.it.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Santangelo
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006222:Hamartoma / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D013154:Spleen / Q000000981:diagnostic imaging / Q000601:surgery; D013156:Splenectomy; D013158:Splenic Diseases / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed