A Case of the Splenic Angiosarcoma with Intraperitoneal Hemorrahage

Masahiko Sugano, Motomi Nasu, Kenji Tsukada, Toshio Takayama, Masayuki Kitajima, Takao Ando, Bunsei Nobukawa*, Yoshiaki Kajiyama, Toshiki Kamano and Masahiko Tsurumaru

First Department of Surgery and First Department of Pathology*, Juntendo University School of Medicine

Primary splenic angiosarcoma is extremely rare. Seventy cases of primary splenic angiosarcoma have been reported in Japan. We experienced a case of spontaneously ruptured splenic angiosarcoma. A 50-year-old woman with abdominal pain and hemorrhagic shock was transported by ambulance to our hospital. Abdominal CT showed splenomegaly with multiple nodules, and hepatomegaly with small nodules. Bloody ascites was recognized by abdominal needle aspiration. An emergency operation was performed to her who was diagnosed massive intraperitoneal hemorrhage. On entering the abdominal cavity, about 3,000 ml of bloody ascites and multiple nodules in the spleen were recognized. Splenectomy was performed because of bleeding from the ruptured spleen. A liver biopsy was also done. The immunohistochemical and the molecularbiological examinations revealed angiosarcoma of the spleen associated with liver metastasis. The patient succumbed 80 days after the operation due to disseminated intravascular coagulation. A probable differential diagnois of angiosarcoma must be kept in mind for splenomegaly.

Key words
angiosarcoma, splenic tumor, Loss of heterozygosity

Reprint requests
Masahiko Sugano First Department of Surgery, Juntendo University School of Medicine
2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421 JAPAN

Accepted
June 25, 2003

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