Primary hemangiosarcoma of the spleen associated with leukocytosis and abnormal spleen scan

A 60-year-old Filipino man, who presented with left sided abdominal pain and weight loss, was found to have splenomegaly, an abnormal spleen scan and a leukemoid reaction. Primary splenic hemangiosarcoma was found at splenectomy. Metastases first occurred in the cervical lymph nodes two years after diagnosis. Despite treatment with doxorubicin and radiation therapy there was recurrence in lymph nodes and scan evidence of liver and bone metastases. The patient died 38 months after diagnosis. A liver-spleen scan is helpful in establishing an early diagnosis, and splenectomy before rupture occurs is advisable. The role of chemotherapy needs to be defined.