Delayed diagnosis of angiosarcoma of the spleen: clinically presenting as recurrent haemoperitoneum following embolisation.

Abstract

Angiosarcoma is a highly aggressive and extremely rare neoplasm of the spleen, with a limited number of reported cases worldwide. We report a case of a 69-year-old man who presented with progressive symptoms of fatigue, abdominal and back pain, anaemia and haemoperitoneum 1 year following embolisation of the spleen for splenic rupture. Additional imaging and colonoscopy with biopsy revealed intra-abdominal fluid and a colonic adenocarcinoma. Diagnostic laparoscopy demonstrated a haemoperitoneum and colon carcinoma, after which splenectomy via laparotomy was performed. Pathology report revealed an angiosarcoma of the spleen with peritoneal tumour deposits. Rupturing of a spleen may be due to an underlying disease. Therefore, the differential diagnosis of splenic rupture should include the possibility of a splenic tumour. The definitive diagnosis and treatment of a splenic angiosarcoma may require splenectomy, although prognosis is poor.

• Authors: Verena Kornmann, Philip van Rijn, Dries Mulder, Koen Reijnders
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Apr 09 2015) ISSN: 1757-790X [Electronic] England
• PMID: 25858933 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Topics

• Aged
• Delayed Diagnosis
• Diagnosis, Differential
• Embolization, Therapeutic (methods)
• Hemangiosarcoma (complications, diagnosis, pathology)
• Hemoperitoneum (diagnosis, etiology, therapy)
• Humans
• Laparotomy (methods)
• Male
• Prognosis
• Spleen (pathology, surgery)
• Splenectomy (methods)
• Splenic Neoplasms (complications, diagnosis, pathology)
• Splenic Rupture (etiology, surgery)