Atraumatic splenic rupture (ASR) is a rare occurrence but an important clinical entity. Although trauma is the most common cause of splenic rupture, there is limited literature on ASR. This case report discusses a 59-year-old woman presenting with tension hydrothorax and ASR in the setting of non-small cell lung carcinoma requiring emergent chest tube insertion and emergent splenectomy. Her hospital course was complicated by pulmonary embolism and thrombosis of the inferior vena cava. The patient expired three months after her initial presentation. This patient’s presentation represents only the second documented case of atraumatic splenic rupture secondary to metastatic lung carcinoma without pathological evidence of splenic metastasis. Atraumatic splenic rupture secondary to metastatic NSCLC is a rare occurrence; though failure to detect, it may be fatal. Pathologic ASR may be an occult presentation of lung malignancy and in the presence of confirmed NSCLC may portend a poor prognosis.

BackgroundWhile atraumatic splenic rupture is rare phenomenon, its potential lethality emphasizes its clinical importance. Disseminated neoplastic disease is a known mechanism of atraumatic splenic rupture. Case PresentationThis case report discusses a patient presenting with tension hydrothorax and atraumatic splenic rupture in the setting of non-small cell lung carcinoma requiring emergent chest tube insertion and splenectomy. This patient’s presentation represents only the second documented case of atraumatic splenic rupture secondary to metastatic lung carcinoma without pathological evidence of splenic metastasis. ConclusionsThis unique case emphasizes the importance of assessing structural integrity of the spleen in patients with metastatic non-small cell lung carcinoma, as neoplastic atraumatic splenic rupture conveys a significant mortality risk.