Splenic angiosarcoma with hepatic and cardiac metastases: a case report and literature review

Figures

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  Figure 1. Radiological findings (A) A tumor within the spleen can be seen compressing the left kidney in the coronal position. (B) Contrast-enhanced CT shows multiple circular mixed-density lesions in the spleen. The size of the lesion in the inferior pole of splenic area is approximately 7.3 cm×6.3 cm×13.6 cm (indicated by the red arrow). Unevenly enhanced lesions can be seen in the V segment of the liver, approximately 3.7 cm×4.1 cm×4.5 cm in size (indicated by the yellow arrow) —consistent with typical SA liver metastasis. (C) An unevenly enhanced lesion with a size of approximately 4.1 cm×4.0 cm×3.5 cm (indicated by the yellow arrow) can be seen in segment VII of the liver. The lesion in the superior pole of the spleen is approximately 7.3cm×6.8cm×7.0cm in size (indicated by the red arrow). (D) Contrast-enhanced CT shows an unevenly enhanced lesion in the right atrium, with a maximum diameter of 7.1 cm (as indicated by the red arrow) —a rare metastatic site in SA, reported in only 1% of cases.

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  Figure 2. Postoperative pathological examination shows that the tumor was composed of atypical epithelioid cells. No cortical or medullary structures were seen in the spleen. A large number of proliferating tumor cells were observed in the field of view, and some showed necrosis (as indicated by the red arrow) —key histological features distinguishing SA from benign vascular tumors.