Diagnosis and treatment of primary splenic angiosarcoma / 中华肝胆外科杂志

ABSTRACT

Objective:To analyze the clinical and imaging features, and treatment and curative effects of primary splenic angiosarcoma.Methods:A retrospective study was conducted on 6 patients with primary splenic angiosarcoma diagnosed histopathologically at the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2019. The clinical characteristics, CT and ultrasound imaging findings, treatment methods and survival outcomes of these patients were analyzed.Results:There were 4 males and 2 females, with an average age of 52.6 years. These 6 patients with primary splenic angiosarcoma had no specific clinical manifestations, and the diagnoses were all confirmed histopathologically after surgery. CT examination of these 6 patients showed that the spleen volume was increased, with splenic space-occupying lesions. The lesions were single in 1 patient and multiple in 5 patients. Some lesions fused with each other. There were multiple intrahepatic metastases in 1 patient. Ultrasound in 3 patients showed enlarged solid hypoechoic spleens, and rich blood flow at the edges. Five patients underwent splenectomy with complete removal of tumors. For the patient with multiple lesions in the spleen and multiple space-occupying lesions in the liver who could not be treated radically, only splenectomy was done. This patient developed significantly more liver lesions 2 months after surgery, and survived for 3 months. Two patients who underwent postoperative adjuvant chemotherapy relapsed at 9 months and 13 months after surgery. They survived for 16 months and 19 months, respectively. A patient who received postoperative adjuvant chemotherapy survived for 27 months without any obvious signs of recurrence. A patient who underwent targeted therapy relapsed after 10 months, and survived for 14 months after surgery. The remaining patient who underwent simple surgery relapsed 4 months after surgery and died 6 months later.Conclusions:Primary splenic angiosarcoma is a highly malignant tumor. In this study, it lacked specific clinical manifestations and imaging features and its diagnosis required histopathological examination. Surgical resection is the main treatment for this disease. Whether surgery combined with postoperative adjuvant therapy is a more effective treatment than surgery alone for splenic angiosarcoma requires more studies in the future to determine.