From the Research
The management of splenic hemangiomatosis should prioritize a spleen-preserving approach, with embolization being a viable option for symptomatic patients or those with giant hemangiomas, as evidenced by a recent case report of successful embolization of a giant splenic hemangioma 1. The goal of management is to balance the risk of spontaneous rupture and hemorrhage with the importance of preserving splenic function to maintain immunity and prevent long-term complications.
- Asymptomatic cases with small hemangiomas can be managed with observation and regular monitoring using ultrasound or CT scans every 6-12 months 2.
- Symptomatic patients or those with giant hemangiomas (>4 cm) may require more invasive management, such as splenectomy or spleen-preserving procedures like partial splenectomy or embolization 3, 4.
- Embolization can serve as a palliative measure or pre-operative adjunct in selected cases, particularly for patients with high surgical risk or those who wish to avoid splenectomy 1, 4.
- The management approach should be individualized based on the patient's symptoms, lesion characteristics, and overall health status, with multidisciplinary input from hematology, interventional radiology, and surgery for complex cases. Key considerations in the management of splenic hemangiomatosis include:
- The risk of spontaneous rupture and hemorrhage, which increases with hemangioma size and growth rate 2, 4.
- The importance of preserving splenic function to maintain immunity and prevent long-term complications, such as increased infection risk and cardiovascular disease 3.
- The role of embolization as a viable option for symptomatic patients or those with giant hemangiomas, as evidenced by recent case reports 1, 4.