A patient with rectal cancer developed a rapidly growing splenic mass 2 years after cancer treatment. Since a metastatic process could not be ruled out, splenectomy was performed, and the tumour emerged as a sclerosing angiomatoid nodular transformation (SANT) of the spleen. SANT is a rare, recently recognised, non-neoplastic vascular lesion of the spleen that radiologically may be difficult to distinguish from vascular splenic lesions such as splenic hamartoma, haemangioma or littoral cell angioma. However, morphologically and immunohistochemically it is separated from those tumours by its unique nodular angiomatoid proliferation pattern. SANT is considered to be a benign lesion. This case is reported because of its important clinical impact for the differential diagnosis of splenic masses. Data regarding growth rates of these lesions are scarce and a growth progression as in this case, that finally led to the indication for splenectomy due to lingering suspicion of malignancy, is novel.
[Show abstract][Hide abstract] ABSTRACT: Sclerosing Angiomatoid Nodular Transformation of the spleen (SANT) is a rare benign vascular lesion of the spleen with extensive sclerosis and unknown etiology.
We report a new case of SANT of the spleen found in a 53-year-old female following detection of a splenic mass on a routine computed tomography (CT). The patient underwent an uncomplicated laparoscopic splenectomy and the specimen was sent for histopathologic examination.
A review of the 97 reported cases of SANT found in the literature was undertaken. There were 43 males and 54 females with a median age of 46 years (range: 11-82 years). SANT is classically considered to be a female predominant disease, however 44.3% of reported case were male and the gender predilection may soon be neutralized as more cases are reported. 65 of the 97 (67%) patients were in 30-60 year age group. The majority of lesions (n=50) were incidentally found on imaging, and for those patients presenting with symptoms, abdominal pain (n=18) was the predominant symptom.
The diagnosis of SANT should be considered in any patient presenting with a splenic lesion that contains an angiomatoid or inflammatory component. As the differential diagnosis for SANT includes malignant pathologies, and currently no reliable diagnostic radiological feature has been identified to differentiate between these conditions, SANT will continue to be diagnosed on the basis of surgical histopathology.
International Journal of Surgery Case Reports 07/2012; 3(10):492-500. DOI:10.1016/j.ijscr.2012.06.003
[Show abstract][Hide abstract] ABSTRACT: We report for the first time on the contrast-enhanced ultrasound (CEUS) features of littoral cell angioma of the spleen (LCA). A patient presented with the incidental finding of splenomegaly which was investigated using modern ultrasound techniques. B-mode technique revealed heterogenous splenic parenchyma and small hypoechoic lesions up to 30 mm in size. Colour Doppler imaging revealed no specific vascularity. CEUS showed arterial hyper- and hypoenhancement with pronounced demarcation in the late phase. In an assumption of malignancy the lesions were biopsied using ultrasound guidance. Histology showed LCA. In this case report we discuss LCA in the light of new ultrasound techniques and present a review of the literature.
Zeitschrift für Gastroenterologie 02/2013; 51(2):209-212. DOI:10.1055/s-0032-1325556 · 1.05 Impact Factor
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