A Case of Splenic Angiosarcoma with Rupture of the Spleen

Abstract

Splenic angiosarcoma is rare and accounts for only 1% of all sarcoma reported. We experienced a case of spontaneously ruptured splenic angiosarcoma. The patient was a 42 year-old man. He presented to the emergency department in our hospital with sudden onset of abdominal pain. Blood examination showed mild anemia, but other laboratory data were normal. Contrast-enhanced computed tomography showed several atypical-shaped low-density areas in the spleen and hemorrhagic ascites around the spleen, liver and in the pelvis. He was diagnosed as having a intra-abdominal hemorrhage with splenic rupture. An emergent operation was performed because we suspected a malignant tumor of the spleen. The spleen was ruptured therefore we performed a splenectomy. Histopathological examination showed spindle cells with atypical nuclei and the enlarged nuclear bodies and the spindle cells were both CD31 and CD34 positive. We diagnosed this case as splenic angiosarcoma. He received outpatient adjuvant chemotherapy for 6 months, and is currently alive for 18 months after surgery with no recurrence.