Successful Chemotherapy for Spontaneous Gastrosplenic Fistula in Diffuse Large B-Cell Lymphoma

Gastrosplenic fistula (GSF) is a rare condition associated with gastric or splenic lymphomas. Surgical resection is the most commonly reported treatment, as has been documented in previous studies. We herein report a case of GSF in a 59-year-old man with diffuse large B-cell lymphoma (DLBCL). The patient was successfully treated with chemotherapy alone without the need for surgical resection. Given the patient's advanced stage and the absence of gastrointestinal bleeding or perforation, chemotherapy was selected as the first-line treatment to avoid the risks associated with surgery. The patient received the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) along with high-dose methotrexate and intrathecal chemotherapy. No complications related to the fistula were observed during treatment, and the patient achieved complete metabolic remission.