Giant splenic hemangioma during pregnancy: a case report

Abstract

Introduction and importance

Giant splenic hemangiomas are rare and pose diagnostic and management challenges, particularly during pregnancy. This case highlights the need for multidisciplinary approach to manage such a massive splenic lesion in the second trimester.

Case presentation

A 34-year-old woman with pre-pregnancy splenic cysts developed left upper quadrant distension at 19 weeks of gestation. Physical examination and preoperative ultrasound confirmed splenic enlargement. Due to concerns for splenic rupture from uterine compression, open splenectomy was performed at 19 weeks + 5 days. Histopathology analysis confirmed splenic hemangioma.

Clinical discussion

Management of splenic hemangioma or other types of massive splenic mass lacks standardized guideline. And imaging alone cannot reliably differentiate type of splenic lesions. In pregnant patients, management should be individualized based on lesion size, symptoms, gestational age, and complication risk of conservative approaches. Treatment options necessitate multidisciplinary collaboration to balance maternal-fetal safety.

Conclusion

This case of giant splenic hemangioma during pregnancy demonstrates that splenectomy in the second trimester is feasible after balancing balance maternal-fetal risks. It emphasizes the necessity of multidisciplinary decision-making to optimize maternal and fetal outcomes in management of complex abdominal masses during pregnancy.