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A splenic 'cyst': histology confirmed splenic sarcoma
1Hull Royal Infirmary, Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.
Annals of the Royal College of Surgeons of England
|April 3, 2020
Summary
Pleomorphic undifferentiated sarcoma (PUS) of the spleen is rare and aggressive. This case highlights that iron-deficiency anemia can be an unusual sign of splenic PUS, prompting consideration of sinister causes.
Area of Science:
- Oncology
- Pathology
- Gastroenterology
Background:
- Primary malignant fibrous histiocytoma, now classified as pleomorphic undifferentiated sarcoma (PUS), is a common soft-tissue sarcoma in adults.
- Primary splenic PUS is exceptionally rare, aggressive, and linked to poor prognoses, with only 14 documented English literature cases.
- Splenic cysts are common, but PUS can mimic them, posing diagnostic challenges.
Observation:
- A 56-year-old woman presented with iron-deficiency anemia, early satiety, and left upper quadrant pain.
- Preoperative diagnosis suggested a large splenic cyst, leading to elective surgical excision.
- Histopathology confirmed the presence of splenic PUS.
Findings:
- The study reviews literature on splenic PUS and its differentials with splenic cysts.
- Iron-deficiency anemia is an atypical symptom for splenic cysts, suggesting other serious pathologies.
Implications:
- This case underscores the need to consider rare and aggressive splenic tumors in differential diagnoses.
- Recognizing unusual symptoms like iron-deficiency anemia can aid in earlier detection of splenic PUS.
