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以脾血管肉瘤作为自发性脾破裂延迟治疗原因的疑难诊断:一例报告及文献综述

Demanding Diagnosis of Splenic Angiosarcoma as Cause of Delayed Treatment of Spontaneous Splenic Rupture: A Case Report and Literature Review.

作者信息

Coppola Sara, Leva Andrea, Pagni Fabio, Famularo Simone, Gianotti Luca

机构信息

School of Medicine and Surgery, Department of Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.

School of Medicine and Surgery, Department of Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy; Department of Pathology, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.

出版信息

Case Rep Surg. 2017;2017:6256102. doi: 10.1155/2017/6256102. Epub 2017 Feb 2.

Abstract

Primary splenic angiosarcoma is a very rare mesenchymal malignant tumor associated with a poor prognosis due to its high metastatic potential. This disease can be easily neglected and spontaneous splenic rupture is a frequent manifestation at the time of diagnosis leading to a poor outcome because of peritoneal dissemination. We describe the case of a 49-year-old man who presented with asthenia, left upper quadrant abdominal pain, and anemia. Computerized tomography scan showed an enlarged spleen with no nodules and a nontraumatic rupture of the splenic capsule. Splenectomy was performed on account of the severe anemia and histopathology examination showed a primary angiosarcoma. Splenic angiosarcoma should be considered as one of the differential diagnoses in patients with nontraumatic spleen rupture and a specific previous medical history. Regrettably, splenectomy allows for a definitive diagnosis but not a curative treatment.

摘要

原发性脾血管肉瘤是一种非常罕见的间叶性恶性肿瘤,因其高转移潜能而预后不良。这种疾病很容易被忽视,自发性脾破裂是诊断时的常见表现,由于腹膜播散导致预后较差。我们描述了一例49岁男性患者,其表现为乏力、左上腹疼痛和贫血。计算机断层扫描显示脾脏肿大,无结节,脾包膜非创伤性破裂。由于严重贫血进行了脾切除术,组织病理学检查显示为原发性血管肉瘤。对于非创伤性脾破裂且有特定既往病史的患者,应将脾血管肉瘤视为鉴别诊断之一。遗憾的是,脾切除术可实现明确诊断,但并非治愈性治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fb8/5312503/41f5844c0519/CRIS2017-6256102.001.jpg

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