Primary splenic angiosarcoma with liver metastasis: A case report and literature review

Abstract

had the surgery; Yang JW has helped the bibliography search; Yang KF has done the data collection and then finished the report.Supported by The First Affiliated Hospital of Nanchang University, Jiangxi Province, China.Institutional review board statement: The research was verified by the First Affiliated Hospital of Nanchang University Institutional Review Board, Nanchang, China.Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment. Conflict-of-interest statement:The authors announced that there is no conflict of interest exists in manuscript, included personal, political, and others. AbstractPrimary splenic angiosarcoma (PSA) is an unusual and highly malignant vascular tumour with a high rate of metastatic. Moreover, the research on prognosis of the disease is poor. The epidemiology, etiology, clinical diagnosis and treatment of the disease remain challenging, because case reports of the disease are few in number. In accordance with other malignant tumors, PSA is very aggressive, and the majority of patients in which this disease is found are at an advanced stage. Almost all patients die within 12 mo of diagnosis irrespective of treatment. We report here a woman who had complained of upper bellyache and anorexia for 10 d. Magnetic resonance imaging showed enlargement of the spleen with multiple heterogeneous masses in the lower pole of the spleen. A hand-assisted laparoscopic splenectomy was performed which allowed histopathologic diagnosis. The patient was diagnosed with PSA and liver metastasis, and succumbed to the disease 35 d after surgery. The literature was finished combined with the clinical features, diagnosis and management of PSA. Core tip: Primary splenic angiosarcoma (PSA) is an unusual tumor originating from the blood vessel. To date, very few cases of PSA have been reported. We report a woman who had PSA after splenectomy, and liver metastasis was also detected. The patient heterogeneous mass of 7.8 cm × 5.7 cm and multiple nodules in the liver parenchyma (Figure 1). So the diagnosis of the primary splenic malignancy with hepatic metastasis was suggested based on imaging findings. A hand-assisted laparoscopic splenectomy was then performed not only for the purpose of curing the disease, but also for histopathologic diagnosis. In this process, the patient had received 2 units of fresh frozen plasma and frozen plasma, 3 units of blood cells and 6 units of cryoprecipitate. Intraoperatively, we observed a scleroid tumor mass 6 cm × 5 cm in size in the lower pole of the spleen. A cross-section of the specimen demonstrated a wellcircumscribed grayish yellow lesion. In accordance with the imaging findings, laparotomy revealed micrometastases in the liver. Thus, a histopathologic biopsy was carried out. The pathologic diagnosis of the excised spleen was originating from the spleen (Figure 2) and liver metastasis, which were confirmed by pathologic examination of the biopsied specimen. Immunohistochemical analysis showed t...

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