Milickovic M, Rasic P, Cvejic S, Bozic D, Savic D, Mijovic T, Cvetinovic S, Djuricic SM. Splenic hamartomas in children. World J Clin Cases 2024; 12(11): 1909-1917 [PMID: 38660549 DOI: 10.12998/wjcc.v12.i11.1909]
Corresponding Author of This Article
Petar Rasic, MD, Surgeon, Department of Abdominal Surgery, Mother and Child Health Care Institute of Serbia "Dr. Vukan Cupic", Radoja Dakica 6-8, Belgrade 11000, Serbia. perasrv@yahoo.com
Research Domain of This Article
Surgery
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2024; 12(11): 1909-1917 Published online Apr 16, 2024. doi: 10.12998/wjcc.v12.i11.1909
Splenic hamartomas in children
Maja Milickovic, Petar Rasic, Sofija Cvejic, Dejana Bozic, Djordje Savic, Tanja Mijovic, Sava Cvetinovic, Slavisa M Djuricic
Maja Milickovic, Petar Rasic, Djordje Savic, Tanja Mijovic, Sava Cvetinovic, Department of Abdominal Surgery, Mother and Child Health Care Institute of Serbia "Dr. Vukan Cupic", Belgrade 11000, Serbia
Maja Milickovic, Djordje Savic, Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
Sofija Cvejic, Department of Radiology, The Children’s University Hospital, Belgrade 11000, Serbia
Dejana Bozic, Slavisa M Djuricic, Department of Clinical Pathology, Mother and Child Health Care Institute of Serbia "Dr. Vukan Cupic", Belgrade 11000, Serbia
Slavisa M Djuricic, Faculty of Medicine, University of Banja Luka, Banja Luka 78000, Bosnia and Herzegovina
Author contributions: Milickovic M, Rasic P, Cvejic S, Bozic D, and Djuricic S significantly contributed to the conceptualization and design of the study; Milickovic M, Rasic P, Cvejic S, Bozic D, Mijovic T, and Cvetinovic S conducted the literature search, data collection, and manuscript drafting; Rasic P, Savic D, and Djuricic S critically revised the article. All authors approved the final manuscript and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Petar Rasic, MD, Surgeon, Department of Abdominal Surgery, Mother and Child Health Care Institute of Serbia "Dr. Vukan Cupic", Radoja Dakica 6-8, Belgrade 11000, Serbia. perasrv@yahoo.com
Received: January 27, 2024 Peer-review started: January 27, 2024 First decision: February 27, 2024 Revised: March 6, 2024 Accepted: March 22, 2024 Article in press: March 22, 2024 Published online: April 16, 2024 Processing time: 74 Days and 23.7 Hours
Abstract
Splenic hamartomas (SHs) are uncommon, benign vascular lesions of unclear etiology and are mostly found incidentally on abdominal images, at surgery, or at autopsy. Since the first case description, in 1861, less than 50 pediatric SH cases have been reported in the literature. In this article, we have performed an analysis of all SH cases in children published in the literature to date and presented our case of an 8-year-old male with SH. These lesions in children were shown to cause symptoms more often than in the adult population. The observed SH sizes in children ranged from a few millimeters to 18 cm, and the symptomatic lesions were mostly larger or multiple. The most common clinical finding was splenomegaly. Signs of hypersplenism were present in children with a single SH larger than 4.5 cm (diameter range: 4.5-18.0 cm) and in those with multiple hamartomas, ranging from a few millimeters to 5 cm. Eighty percent of patients with available laboratory findings had hematological abnormalities such as anemia, thrombocytopenia, or pancytopenia. Other symptoms and signs included abdominal pain, recurrent infections, fever, night sweats, lethargy, growth retardation, and weight loss. The use of multiple imaging modalities may suggest the preoperative diagnosis of a splenic mass in children and determine the therapeutic approach. However, the final diagnosis of SH relies on histopathological evaluation. Surgery, including total or partial splenectomy (PS), is the mainstay of SH management. Although total splenectomy carries a greater risk of overwhelming post-splenectomy infection than PS it has remained the most performed surgical procedure in children with SH. In the majority of pediatric patients with symptomatic SH, resolution of symptoms and resolution or improvement of cytopenias occurred after surgical treatment.
Core Tip: This article provides a comprehensive analysis of all splenic hamartoma (SH) cases in children published in the literature until 2023 and presents our case of an 8-year-old male with SH. The relevant literature in English on pediatric SH was searched with special reference to demographic, clinical, radiological, and pathological features and treatment. The literature search was performed using Medline via the PubMed database, Google Scholar, and Cochrane Database, using the following terms: “splenoma”; “hamartoma”; “spleen”; “masses”; “lesion” and “children”. Forty-six histopathologically confirmed SHs in children were found in the literature.
