Liu Denghui,Li Yong,Xiao Yaling,et al.Clinical characteristics and outcomes of splenic tumor in children[J].Journal of Clinical Pediatric Surgery,,19():705-710.[doi:10.3969/j.issn.1671-6353.2020.08.009]
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Clinical characteristics and outcomes of splenic tumor in children

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第19卷 Number: 2020 08 Page: 705-710 Column: 儿童肿瘤 Date of publication: 2020-08-20
Author(s):
Liu Denghui1;  Li Yong1;  Xiao Yaling1;  Yin Qiang2;  Li Ming1;  Tang Xianglian1;  Zhou Yuxiang1;  Huang Zhao1
1. Department Ⅱ of General Surgery, Children’s Hospital of Hunan Province, Changsha 410007, China;
2. Department Ⅰ of General Surgery, Children’s Hospital of Hunan Province, Changsha 410007, China
Keywords:
Splenic Neoplasms/SU; Treatment Outcome; Child
CLC:
R567.6;R733.2
DOI:
10.3969/j.issn.1671-6353.2020.08.009
Abstract:
Objective To explore the clinical features, treatment strategies and outcomes of children with splenic tumor. Methods From January 2010 to December 2019, clinical data were retrospectively analyzed for 24 children of splenic tumor. There were 14 boys and 10 girls with a median age of 7.2 years. Results The tumors were benign(n=20) and malignant(n=4). Benign tumors were managed by splenectomy & autologous splenic slice transplantation(n=4), laparoscopic partial splenectomy(n=8), open splenectomy(n=4), splenic cyst drainage & cyst top-to-bottom destruction(n=1) and interventional therapy for splenic hemangioma(n=3). Malignant tumors were removed by splenectomy, removal of metastatic lesions and splenic hilum lymph node dissection, with implantable venous infusion port for adjuvant chemotherapy. During follow-ups, benign tumors patients had an excellent recovery. For primary malignant tumors(n=3), the longest 6-year follow-up was until June 2019 and three cases survived. One child died at Month 5 post-operation. Other children showed no recurrence of splenic tumor, vascular embolism or over-helming postsplenectomy infection. Conclusion Laparoscopic splenectomy is a major option for benign splenic tumors in children. Spleen is an important organ of immune system in children, benign splenic tumors should be managed by partial splenectomy or splenectomy plus splenic omentum autologous splenic slice transplantation. However, malignant splenic tumors are better treated by radical laparotomy and chemotherapy. Benign splenic tumors have a better prognosis while the outcomes of malignant ones are poor. Earlier diagnosed, radical operation and chemotherapy improve outcomes for primary splenic malignant tumors.

References:

1 黄珊,徐冰,胡耀宗,等.小儿脾脏良性肿瘤的诊治[J].肝胆外科志,2018,26(2):126-129.DOI:10.3969/j.issn.1006-4761.2018.02.014.Huang S,Xu B,Hu YZ,et al.Surgical diagnosis and treatment of splenic benign tumors in children[J].Journal of Hepatobiliary Surgery,2018,26(2):126-129.DOI:10.3969/j.issn.1006-4761.2018.02.014.
2 Silver DS,Pointer DT,Slakey DP.Solid tumors of the spleen:evaluation and management[J].J Am Coll Surg,2017,224(6):1104-1111.DOI:10.1016/j.jamcollsurg.2016.12.043.
3 Zheng L,Deng CL,Li J,et al.Treatment of hemangioma of the spleen by preoperative partial splenic embolization plus laparoscopic partial splenectomy:A ease report[J].Medicine (Baltimore),2018,97(17):1-4.DOI:10.1097/MD.0000.000000009940.
4 Liu QD,Song Y,Zhou NX,et al.Radiofrequeney ablation of splenic tumors:a case series[J].J Gastrointestin Liver Dis,2013,22(1):105-108.
5 李宗芳,张澍.脾脏的基础研究进展与展望[J].西安交通大学学报(医学版),2008,29(1):1-5.DOI:10.3969/j.issn.1671-8259(2008) 01-0001-06.Li ZF,Zhang S.The progress and prospect of fundamental research of the spleen[J].Journal of Xi’an Jiaotong University (Medical Sciences),2008,29(1):1-5.DOI:10.3969/j.issn.1671-8259(2008) 01-0001-06.
6 Boyer TD,Habib S.Big spleens and hypersplenism:fix it or forget it?[J].Liver Int,2015,35(5):1492-1498.DOI:10.1111/liv.12702.
7 Willcox TM,Speer RW,Schlinkert RT,et al.Hemangioma of the spleen:presentation,diagnosis and management[J].J Gastrointest Surg,2000,4(6):611-613.DOI:10.1016/s1091-255x(00)80110-9.
8 Vancauwenberghe T,Snoeckx A,Vanbeckevoort D,et al.Imaging of the spleen:what the clinician needs to know[J].Singapore Med J,2015,56(3):133-144.DOI:10.11622/smedj.2015040.
9 Jang S,Kim JH,Hur BY,et al.Role of CT in Differentiating Malignant Focal Splenic Lesions[J].Korean J Radiol,2018,19(5):930-937.DOI:10.3348/kjr.2018.19.5.930.
10 Sepulveda W,Ochoa JH,Cafici D,et al.Splenic cyst as a rare cause of fetal abdominal cystic mass:A multicenter series of nine cases and review of the literature[J].Ultrasound,2018,26(1):22-31.DOI:10.1177/1742271X17747138.
11 Siwon J,Jung HK,Bo YH,et al.Role of CT in differentiating malignant focal splenic lesions[J].Korean J Radiol,2018,19(5):930-937.DOI:10.3348/kjr.2018.19.5.930.
12 Nobashi T,Baratto L,Reddy SA,et al.Predicting response to immunotherapy by evaluating tumors,lymphoid cell-rich organs and immune-related adverse events using FDG-PET/CT[J].Clin Nucl Med,2019,44(4):e272-e279.DOI:10.1097/RLU.0000000000002453.
13 Zhao Q,Dong A,Wang Y,et al.FDG PET/CT in primary splenic angiosarcoma with diffuse involvement of the spleen[J].Clin Nucl Med,2017,42(10):815-817.DOI:10.1097/RLU.0000000000001805.
14 Alan FU,Paolo G,Kendall K,et al.Laparoscopic Splenectomy:Has It Become the Standard Surgical Approach in Pediatric Patients?[J].J Surg Res,2019,240:109-114.DOI:10.1016/j.jss.2019.02.045.
15 Cheng J,Tao KX,Yu PW.Laparoscopic splenectomy is a better surgical approach for spleen-relevant disorders:a comprehensive metaanalysis based on 15-year literatures[J].Surg Endosc,2016,30(10):4575-4588.DOI:10.1007/s00464-016-4795-z.
16 Jiang HC,Liu LX,Wang JZ,et al.Can the spleen be divided into two functional parts?[J].J Clin Gastroenterol,2014,48(3):261-263.DOI:10.1097/MCG.Ob013e31829e4534.
17 Choi W,Choi YB.Splenic embolization for a giant splenic hemangioma in a child:a case report[J].BMC Pediatr,2018,18(1):354.DOI:10.1186/s12887-018-1331-4.
18 马盼飞,麻勇,姜洪池.脾囊肿外科处理的变迁及今日观[J].中华肝脏外科手术学电子杂志,2019,8(2):104-107.DOI:10.3877/cma.j.issn.2095-3232.2019.02.006.Ma PF,Ma Y,Jiang HC.The changes and present views of surgical management of splenic cyst[J].Chinese Journal of Hepatic Surgery,2019,8(2):104-107.DOI:10.3877/cma.j.issn.2095-3232.2019.02.006.
19 Eris C,Akbulut S,Yildiz MK,et al.Surgical approach to splenic hydatid cyst:single center experience[J].Int Surg,2013,98(4):346-353.DOI:10.9738/INTSURG-D-13-00138.1.
20 Guan YS,Hu Y.Clinical application of partial splenic embolization[J].Scientific World Journal,2014,2014:961345.DOI:10.1155/2014/961345.
21 Grzesik P,Wu JK.Current perspectives on the optimal management of infantile hemangioma[J].Pediatric Health Med Ther,2017,8:107-116.DOI:10.2147/PHMT.S115528.
22 Luu S,Spelman D,Woolley IJ.Post-splenectomy sepsis:preventative strategies,challenges,and solutions[J].Infect Drug Resist,2019,12:2839-2851.DOI:10.2147/IDR.S179902.
23 徐冰,彭兵,曹李明,等.儿童腹腔镜脾切除术35例分析[J].临床小儿外科杂志,2013,12(3):216-218.DOI:10.3969/jissn.1671-6353.2013.03.016.Xu B,Peng B,Chao LM,et al.Laparoscopic splenctomy in children:a report of 35 cases[J].J Clin Ped Sur,2013,12(3):216-218.DOI:10.3969/jissn.1671-6353.2013.03.016.
24 尹强,周小渔,刘朝阳,等.小儿全腹腔镜下脾切除术体位与显露探讨[J].临床小儿外科杂志,2017,16(1):73-76.DOI:10.3969/jissn.1671-6353.2017.01.017.Yin Q,Zhou XY,Liu CY,et al.Position choice and exposure technique during pediatric laparoscopic splenctomy[J].J Clin Ped Sur,2017,16(1):73-76.DOI:10.3969/jissn.1671-6353.2017.01.017.
25 Sauer J,Sobolewski K,Dommisch K.Splenic metastases-not a frequent problem,but an underestimate location of metastases:epidemiology and course[J].J Cancer Res Clin Oncol,2009,135(5):667-671.DOI:10.1007/s00432-008-0502-3.
26 Rizzo F,Calamia S,Mingoia G,et al.Isolated metachronous splenic metastasis from colon cancer:possible explanations for this rare entity[J].J Gastrointest Cancer,2019,50(1):143-146.DOI:10.1007/s12029-017-9992-z.
27 Wakasugi M,Yasuhara Y,Nakahara Y,et al.Primary splenic malignant lymphoma mimicking metastasis of rectosigmoid cancer:a case report[J].Int J Surg Case Rep,2018,44:11-15.DOI:10.1016/j.ijscr.2018.01.022.
28 Kalpadakis C,Pangalis GA,Angelopoulou MK,et al.Treatment of splenic marginal zone lymphoma[J].Best Pract Res Clin Haematol,2017,30(1-2):139-148.DOI:10.1016/j.beha.2016.07.004.
29 Byrd KP,Vontela NR,McCullar B,et al.Multi-database description of primary splenic diffuse large B-cell lymphoma[J].Anticancer Res,2017,37(12):6839-6843.DOI:10.21873/anticanres.12145.
30 Jo VY,Doyle LA.Refinements in sarcoma classification in the current 2013 World Health Organization Classification of Tumours of Soft Tissue and Bone[J].Surg Oncol Clin N Am,2016,25(4):621-43.DOI:10.1016/j.soc.2016.05.001.
31 Zhen NY,Li BX,Zhen GZ.et al.Clinicopathological features and prognosis of malignant peripheral nerve sheath tumor:a retrospective study of 159 cases from 1999 to 2016[J].Oncotarget,2017,8(62):104785-104795.DOI:10.18632/oncotarget.18975.
32 Morgenstern L,Rosenberg J,Geller SA.Tumors of the spleen[J].World J Surg,1985,9(3):468-476.DOI:10.1007/BF01655283.
33 Dimitrov Dimitrov D.Laparoscopic splenectomy for solitary splenic metastasis in patients with previous open surgery-case series[J].Int J Surg Case Rep,2019,65:83-86.DOI:10.1016/j.ijscr.2019.10.044.

Memo

收稿日期:2020-06-10。
基金项目:湖南省自然科学基金（编号：2018JJ2210）
通讯作者:李勇,Email:liyongpuwaike@163.com

Last Update: 1900-01-01