Spontaneous splenic artery rupture in a patient with an unclassified malignant spindle cell tumor of the spleen: report of a case

Abstract

The purpose of this paper was to describe an unusual manifestation of a sarcoma of the spleen and to raise awareness for spontaneous rupture of the splenic vessels in patients with splenic tumors. A 70-year-old man was admitted to our institution, suffering from left upper quadrant abdominal pain. Upon physical examination, a large and tender abdominal mass was palpated. Abdominal computed tomography showed a heterogenous enlarged spleen with active contrast extravasation from the splenic artery, free intraperitoneal fluid, and a retroperitoneal hematoma. The patient was treated with angioembolization of the splenic artery. Because of rebleeding, splenectomy was performed. Pathology revealed the spleen to be involved with an unclassified malignant spindle cell neoplasm. We concluded that in the case of spontaneous rupture of the splenic artery, accompanied with a radiologic appearance of an enlarged spleen, the diagnosis of sarcoma should be included in the differential diagnosis.

Splenic Artery Embolization and Splenectomy for Spontaneous Rupture of Splenic Hemangioma and Its Imaging Features

“…However, compared with splenectomy, SAE has the risk of rebleeding, and splenectomy is still needed in the end. Swaid (11) and Spittle (19) have similar reports of splenectomy after SAE failure.…”

“…Spontaneous splenic rupture treatment includes total splenectomy (84.1%), organ-sparing surgery (including splenoplasty and partial splenectomy) (1.2%), or conservative treatment (14.7%) (1). A third treatment option, splenic artery embolization (SAE), has only recently been reported (11)(12)(13).…”