Introduction. According to the guidelines of the European Association of
Endoscopic Surgery (EAES), any case where the maximum craniocaudal splenic
diameter exceeds 20 cm is considered as massive splenomegaly. In addition to
metabolic, hematological, and hemodynamic problems enlarged spleen may cause
mechanical difficulties due to the pressure to surrounding organs and
vascular structures. The aim of this paper is to present the surgical
challenges and technique applied in massive splenomegaly, in a patient who
had neglected the importance of regular medical checkups. Case outline. We
present a 62-year-old male patient who was admitted to hospital for
treatment of previously clinically and radiologically verified splenomegaly
but who neglected the importance of regular checkups and medical treatment.
Splenectomy was performed with splenic specimen 38 cm in its maximal
diameter. Conclusion. Taking into consideration all the possible benefits
and possible complications of surgical treatment, including the quality of
life of splenectomized patients, comprehensive preoperative assessment
should be made, and surgical treatment selectively applied.