Splenic hemangioma with steroid induced avascular necrosis

Case contributed by Dr Ahmed Abdrabou


Patient with abdominal pain and history of thrombocytopenia.

Patient Data

Age: 55 years
Gender: Female

The spleen is enlarged with a large ill-defined hypodense lesion that contains central foci of calcification. The lesion displays progressive centripetal filling after contrast administration. A note is made of severe bilateral avascular necrosis of femoral heads with secondary osteoarthritic changes. Cardiomegaly is also noted.

Diagnosis: splenic hemangioma causing thrombocytopenia and complicated by steroid-induced femoral head avascular necrosis.

Case Discussion

The patient had thrombocytopenia and was thought to be autoimmune and hence she was treated with corticosteroids. The corticosteroids caused bilateral femoral head avascular necrosis and secondary osteoarthritis. The real cause for the thrombocytopenia was large splenic hemangioma which sequestrated and destroyed the platelets and though the accurate treatment should be splenectomy.

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Case information

rID: 26485
Published: 23rd Dec 2013
Last edited: 21st Sep 2020
Inclusion in quiz mode: Included

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