Littoral Cell Angioma of the Spleen

Background: Littoral cell angioma is a rare vascular tumour unique to the spleen, originating from cells lining the venous sinuses of the normal spleen.  It was first described by Falk et al. in 1991.  The majority of cases have been composed of multiple nodules of varying sizes in the spleen, benign and asymptomatic in nature.  Case Summary: The patient is a 54 year old, presenting with a 4 month history of worsening lower back pain, radiating to both lower limbs.  CT Thorax Abdomen and Pelvis was carried out which showed a 6.2cm dense fluid density lesion in the spleen.  The case was discussed at the multidisciplinary team meeting and open splenectomy was carried out.  Histological diagnosis was consistent with an infarcted littoral cell angioma. Conclusion: Littoral cell angioma is a benign tumour of the spleen, which may be associated with malignancy, immunological and congenital disorders.  The treatment of choice is splenectomy.  The imaging features of many other splenic neoplasms may mimic those of littoral cell angioma but in such cases diagnostic signs and symptoms are usually present.  In cases of incidental finding of splenic mass on imaging and the patient has no associated signs or symptoms, littoral cell angioma should be suspected.