A Case of Multiple Sclerosing Angiomatoid Nodular Transformation (SANT) of the Spleen

Abstract

A 61-year-old man with anorexia and weight loss was found to have multiple splenic tumors with a maximum diameter of 12 cm on CT scan. We suspected malignant lymphoma or hemangiosarcoma, but imaging and bone marrow biopsy failed to reach a definite diagnosis, and we performed an open splenectomy for histological diagnosis and treatment. Multiple masses were found in the spleen, each of them measuring 7.5×5.5 cm, 4.0×4.0 cm, 3.5×4.0 cm, and 3.0×10.0 cm, respectively. Immunostaining showed mixed findings of three types of vascular components (cord capillary, sinusoid, and small veins), and the histopathological diagnosis of sclerosing angiomatoid nodular transformation (SANT) was made. SANT is a rare benign lesion of the spleen, which was first reported in 2004, and is often discovered incidentally as a single, asymptomatic lesion. In Japan, there have been no reports of multiple cases exceeding 10 cm in size. In this report, we describe a case of multiple SANT presented with anorexia and resected, with some discussion of the literature.