title: 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: Department of Surgery, Slingeland Hospital Doetinchem, Doetinchem, The Netherlands.
authors: Verena
authors: V
authors: Kornmann
authors: Department of Radiology, Slingeland Hospital, Doetinchem, The Netherlands.
authors: Philip
authors: P
authors: van Rijn
authors: Department of Pathology, Rijnstate Hospital, Arnhem, The Netherlands.
authors: Dries
authors: D
authors: Mulder
authors: Department of Surgery, Slingeland Hospital Doetinchem, Doetinchem, The Netherlands.
authors: Koen
authors: K
authors: Reijnders
mesh_terms: D000368:Aged; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods; D006394:Hemangiosarcoma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006465:Hemoperitoneum / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D011379:Prognosis; D013154:Spleen / Q000473:pathology* / Q000601:surgery; D013156:Splenectomy / Q000379:methods; D013160:Splenic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D013161:Splenic Rupture / Q000209:etiology / Q000601:surgery