Splenic peliosis – a potentially fatal condition which can mimick malignancy

Gurpreet Singh-Ranger,Noleen Rajarajan,David Stoker,Syed Aftab

doi:10.1186/1477-7800-4-27

Abstract

Isolated splenic peliosis is an extremely rare occurrence, and this disease often manifests itself with spontaneous haemoperitoneum.We report a case where an otherwise healthy patient was found to have splenomegaly on clinical examination. On computerised tomography, a diagnosis of splenic malignancy was made, and the patient underwent a splenectomy. Histological examination gave the diagnosis of splenic peliosis, which had not been considered prior to the operation. In retrospect, splenectomy was the most prudent course of action, as the risk of spontaneous haemorrhage and fatality was eliminated. This case emphasises the need to retain an index of suspicion for this condition, even in otherwise healthy patients, and is a reminder of the usefulness of total splenectomy in the current era of minimally invasive diagnostic techniques.

Highlights

Peliosis is a rare condition of unknown aetiology, characterized by the presence of multiple blood-filled cysts within the parenchyma of solid organs [1]
We describe a case of asymptomatic idiopathic splenic peliosis, in which a patient presented with an incidental splenic mass on computerised tomography
The term peliosis arises from a Greek term meaning "blackish-bluish with sugillation", and was first used by Wagner in 1861 to describe the gross appearance of lesions found on the cut surface of a liver affected by the disease [2]

Summary

Background

Peliosis is a rare condition of unknown aetiology, characterized by the presence of multiple blood-filled cysts within the parenchyma of solid organs [1]. Splenic peliosis has been found to be associated with chronic debilitating conditions, for example, malignancy, and with ingestion of certain medications, such as anabolic steroids. It has been reported in the literature as a consequence of its complications, namely, spontaneous rupture leading to haemoperitoneum [1]. We describe a case of asymptomatic idiopathic splenic peliosis, in which a patient presented with an incidental splenic mass on computerised tomography. This lesion had radiological features indistinguishable from a primary splenic malignancy, and the patient subsequently underwent a splenectomy. The cause of his original haemoptysis, which ceased prior to the surgery, was never elucidated

Discussion

Findings

Wagner E