Hepatocellular carcinoma often has a background of cirrhosis with portal hypertension. Splenomegaly is one of the manifestations of portal hypertension.
Some patients with liver tumors have concomitant cirrhosis, but the degree of cirrhosis is not high and the liver reserve function is assessed to tolerate hepatectomy. Simultaneous portal hypertension due to cirrhosis is dominated by simple splenomegaly and hypersplenism, resulting in low platelets and prolonged clotting time, but not severe esophagogastric fundic varices.
Doctors in this particular case recommend removal of the spleen at the same time as hepatectomy, which can relieve the splenomegaly and hypersplenism problems and also partially reduce portal vein pressure.