Spontaneous rupture of spleen due to
malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute
abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with
hypotension. Ultrasonography revealed mild
splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute
abdominal pain and hemodynamic instability, he underwent
splenectomy with
splenic rupture as the source of
bleeding. Histologic examination showed diffuse infiltration by
tumor. Immunohistochemical study (positive for S100, HMB45, and
vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and
chromogranin) confirmed metastatic
malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic)
rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic
metastasis.
Metastasis of
malignant melanoma is one of the rare causes of the
spontaneous rupture of spleen.