Laparoscopic splenectomy for splenic hamartoma in elderly patien Case report and review of the literature e-publish 25 October 2012 Ann. Ital. Chir 1 Ann. Ital. Chir. e-publish 25 October 2012 pii: S2239253X12020208 www.annitalchir .com Pervenuto in Redazione Giugno 2012. Accettato per la pubblicazione Settembre 2012 Correspondence to: Dr. Andrea Cavallaro, Department of Surgery, Via Canova 2, San Giovanni La Punta - Catania 95037, Italy.(e-mail: andreacavallaro@tiscali.it) Gaetano Piccolo*, Andrea Cavallaro*, Vincenzo Antonacci**, Alfio Nicosia**, Carmelo Iozzia**, Vincenzo Cavallaro***, Vincenzo Minutolo*** *Department of Surgery, General Surgery and Breast Unit, University of Catania, Catania, Italy **Department of Surgery, General Surgery Unit of Ragusa Hospital, Ragusa, Italy ***Laparoscopic Surgery Division, Department of Surgical Sciences, Transplants and Advanced Technologies, Unversity of Catania, Italy. Laparoscopic splenectomy for splenic hamartoma in elderly patien. Case report and review of the literature AIM: We proved the feasibility and the safety of the laparoscopic splenectomy for splenic hamartoma in elderly patients. MATERIAL AND METHODS: We present the first case of laparoscopic splenectomy for splenic hamartoma in elderly patients and we reviewed the English literature regarding the laparoscopic approach. RESULTS: A 74-year-old man with a 6-month history of left upper quadrant abdominal and back pain was referred to our hospital for the evaluation of a splenic mass detected by ultrasonography. Computerized tomography scan (CT) revealed the presence of a solid tumor in the upper pole of the spleen (size 5.3 x 4.5 cm). The diagnosis of a malignant tumor was not excluded completely and because of increasing severe left upper quadrant pain, after three days the patient under- went laparoscopic splenectomy and the final pathological diagnosis was splenic hamartoma. The patient’s postoperative course was uneventful and the patient was discharged by the sixth postoperative day. CONCLUSIONS: Splenectomy is still necessary for diagnostic and therapeutic purposes and mini-invasive surgical technique today represents the standard procedure for the management of any space-occupying lesions of the spleen also in elderly patients. KEY WORDS: Elderly patients, Hamartoma, Laparoscopic splenectomy, Management Introduction Solid tumors of the spleen are relatively rare. Among them the most important malignant tumor of the spleen is lymphoma 1 . Other less common malignancies include primary splenic angiosarcomas, plasmacytomas, primary malignant fibrous histiocytomas and metastases from non-gastroin- testinal malignancies (lung, breast, uterus, ovary and melanoma) 2-4 . On the other hand, vascular tumors are the most impor- tant benign, non-hematologic splenic lesions. Splenic hamartoma is an extremely rare vascular tumor with an incidence of 3 in 200,000 splenectomies and represents an aberrant mixture of normal splenic elements 5 . Although splenic hamartomas are benign and usually asymptomatic it is very difficult to obtain the exact diag- nosis of nature, so many patients finally undergo splenec- tomy 6,7 . We present the first case of laparoscopic splenectomy for splenic hamartoma in elderly patient.