Why the study?
Primary splenic angiosarcoma is a rare, aggressive malignancy carrying a poor prognosis.
Aggressive splenic angiosarcoma can present with a 'dual-negative' pattern on 18 F-FDG and 68 Ga-FAPI PET/CT, underscoring the need for multimodal evaluation.
Warrants multimodal imaging despite dual PET negativity in suspected splenic angiosarcoma; hypothesis-generating for false-negative mechanisms in aggressive sarcomas.
Primary splenic angiosarcoma is a rare, aggressive malignancy carrying a poor prognosis. A 65-year-old woman with a pathologically confirmed well-differentiated splenic angiosarcoma developed liver metastases 5 months into follow-up. Subsequent 18 F-FDG and 68 Ga-FAPI PET/CT imaging revealed a “dual-negative” pattern, demonstrating no significant radiotracer uptake in the metastatic liver lesions. Despite well-differentiated histology, the tumor showed rapid progression, confirming aggressive behavior in well-differentiated angiosarcoma. The high-grade splenic angiosarcoma demonstrated negative findings on dual-tracer PET/CT, underscoring that vigilance and comprehensive multimodal evaluation are crucial for such occult malignancies.
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Xie et al. (2026) studied this question.
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