Objective To diacuss the experience in diagnosis and treatment of primary splenic neoplasm. MethodsThe clinical data of 52 cases of primary splenic neoplasm were analyzed retrospectively from Aug. 1977 to Nov, 2010. 29 cases were benign and 23 were malignant. Among benign patients 25 cases were received splenectomy, 1 case splenic embolization, 3 cases refused operation. Among malignant patients 8 cases were received splenectomy, 8 cases splenectomy and resection of pancreatic body and tail, 3 cases of primary malignant lymphoma, 1 case of leiomyosarcoma and 1 case of lymphosarcoma were performed with laparotomy and biopsy because of widespread abdominal metastasis. 2 cases refused operation. Results The prognosis of benign patients was good. Follow-up of 18 cases of malignant tumors, the survival time was more than 2 years after surgery in 7 cases who were treated in early stage, 1 to 2 years in 6 cases, less than 1 year in 4 cases, one patient died 7 days after operation. ConclusionsThe diagnosis of splenic tumors relies on clinical manifestations and imaging examinations. Ultrasonography was the first choice. Splenectomy was the effective treatment for benign patients. Early diagnosis, radical surgery and postoperative combined therapy is the important means to improve the prognosis of spleen cancer.%目的 探讨原发性脾脏肿瘤的临床诊治经验.方法 回顾性分析本院1977年8月-2010年11月收治的52例原发性脾脏肿瘤患者的临床资料,其中良性肿瘤29例,恶性肿瘤23例.良性肿瘤患者中25例行脾切除术,1例动脉瘤行脾脏栓塞术,3例拒绝手术.恶性肿瘤中8例行单纯脾切除术,8例行脾脏切除加胰腺体尾部切除,3例原发性恶性淋巴瘤,1例平滑肌肉瘤及1例淋巴肉瘤的患者剖腹探查因腹腔广泛转移仅行病理活检,2例拒绝手术.所有病例无手术并发症.结果 脾脏良性肿瘤预后良好,随访的18例恶性肿瘤中术后生存2年以上7例,均为早期治疗的患者,存活1-2年的6例,不到1年的4例,1例患者术后第7天死亡.结论 脾脏肿瘤的诊断主要依靠临床表现及影像学检查,B超为首选检查.脾脏良性肿瘤行手术切除是有效的治疗方法.早期诊断、根治手术和术后综合治疗是改善脾脏恶性肿瘤预后的重要手段.
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