Laparoscopic-Assisted Microwave Ablation for Splenic Hemangioma: A Case Report and Literature Review.

BACKGROUND Hemangioma is the most common benign primary tumor of the spleen and is often detected incidentally. Laparoscopic-assisted microwave ablation (LMWA) has recently been introduced as a novel approach for managing splenic hemangioma. This report describes the case of a 67-year-old woman with an asymptomatic, progressively enlarging splenic hemangioma successfully treated with LMWA. CASE REPORT A 67-year-old woman was admitted for evaluation of a gradually enlarging splenic mass found during routine examination. She was asymptomatic, with normal tumor markers and a mildly elevated D-dimer level. Contrast-enhanced CT revealed a 6.0 cm hypervascular lesion in the upper pole of the spleen. After multidisciplinary discussion, LMWA was performed under direct laparoscopic visualization. The lesion was completely ablated, with a total operative time of 80 minutes, including 25 minutes of ablation. Estimated blood loss was minimal (20 mL). Postoperative pathology examination confirmed a splenic cavernous hemangioma. The postoperative course was uneventful, and she was discharged on day 5. Follow-up imaging showed reduction of the ablation zone to 5.4 cm, and laboratory results returned to normal. CONCLUSIONS This is the first report on the feasibility and safety of LMWA for treating splenic hemangioma. This approach effectively reduces intraoperative bleeding and postoperative hemolysis while preserving splenic function, offering a novel treatment option for splenic hemangioma.