Surgical management of a littoral cell angioma of the spleen

Littoral cell angioma is a rare primary vascular tumor of the spleen taking its origin from littoral cells lining the red pulp venous sinuses of the reticuloendothelial system of the spleen. Throughout the literature, most patients report in an asymptomatic manner with littoral cell angioma presenting as an incidental finding on radiological imaging. Due to their rarity, these tumors can pose diagnostic and therapeutic challenges. The accepted strategies for diagnosis, treatment, and surveillance are based off a limited amount of published data. Our case describes a 61-year-old male who presented to the emergency department for gastrointestinal bleed secondary to gastric ulcers. He subsequently had radiological imaging completed which showed a lesion in his spleen that caused concern for malignancy due to the enhancement patterns on magnetic resonance imaging. The patient wished for surgical resection versus ongoing radiological surveillance and underwent a laparoscopic splenectomy. He was discharged post-operative day one without complications. Pathology confirmed littoral cell angioma. The patient was doing well at follow up. This article provides an in-depth review into the diagnosis and management of a littoral cell angioma of the spleen.