Primary Splenic Angiosarcoma with Retroperitoneal Invasion: A Case Report

Angiosarcoma esplénico primario con invasión retroperitoneal: reporte de caso

Authors

  • Carlos Alfredo Iñiguez Guzmán Universidad Católica de Cuenca
  • Joel Sebastian Vintimilla Contreras Universidad Católica de Cuenca

DOI:

https://doi.org/10.22258/hgh.v10i2.431

Abstract

Primary splenic angiosarcoma is an extremely rare malignant vascular neoplasm of endothelial lineage, characterized by high biological aggressiveness and a generally poor prognosis. We report the case of a 78-year-old male presenting with chronic abdominal pain. Multidetector computed tomography (MDCT) identified a 13-cm heterogeneous splenic mass with areas of necrosis and a peripheral enhancement pattern characteristic of this disease. An exceptional finding in this report was the tumoral extension into the retroperitoneal space, involving infiltration of the lateroconal fascia and compromise of the left renal vein, along with metastatic para-aortic lymphadenopathy. Contrast-enhanced CT was instrumental in characterizing the lesion morphology and establishing advanced local extension, enabling differentiation from other primary splenic tumors. Given its high mortality rate and the challenges of preoperative diagnosis, angiosarcoma must be considered a critical differential diagnosis when encountering splenic masses with infiltrative behavior. Keywords: Retroperitoneal Space; Hemangiosarcoma; Splenic Neoplasms; Multidetector Computed Tomography (Source: MeSH, NLM).

Downloads

Download data is not yet available.

Author Biographies

Carlos Alfredo Iñiguez Guzmán, Universidad Católica de Cuenca

Médico especialista en imagenología y docente de la cátedra de Imagenología en la carrera de Medicina de la Universidad Católica de Cuenca, Ecuador.

Joel Sebastian Vintimilla Contreras, Universidad Católica de Cuenca

Interno Rotativo de Medicina en el Hospital de Especialidades Eugenio Espejo, Quito, Ecuador. Estudiante de la Universidad Católica de Cuenca.

References

Damouny M, Mansour S, Khuri S. Primary Angiosarcoma of the Spleen: An Aggressive Neoplasm. World J Oncol. 2022;13(6):337-342. DOI: 10.14740/wjon1542.

Falk S, Krishnan J, Meis J. Primary angiosarcoma of the spleen: a clinicopathologic study of 40 cases. Am J Surg Pathol. 1993;17(10):959-70. DOI: 10.1097/00000478-199310000-00001.

Avilés-Salas A, Luévano-González A. Primary angiosarcoma of the spleen. Report of one case. Rev Med Chil. 2007;135(9):1178-1181. DOI: 10.4067/s0034-98872007000900013.

Teco-Cortés JA, Navarrete-Pérez JJ, Sánchez-Castro ÓE. Primary splenic angiosarcoma with capsular rupture and disseminated: a case report. Cir Cir. 2021;89(Suppl2):59-63. DOI: 10.24875/ciru.21000118.

Neuhauser TS, Derringer GA, Thompson LD, Fanburg-Smith JC, Miettinen M, Saaristo A, et al. Splenic angiosarcoma: a clinicopathologic and immunophenotypic study of 28 cases. Mod Pathol. 2000;13(9):978-987. DOI: 10.1038/modpathol.3880178.

Dirven I, Leclercq P, D´Hondt L, Delmotte V, Lefesvre P, Reynaert H, et al. Primary splenic angiosarcoma: a case series of a rare oncological entity and diagnostic challenge. Acta Oncol. 2024;63:15-20. DOI: 10.2340/1651-226x.2023.35412.

Fragos GR, Santos EP, Marques CM, Lima RB. Histographical and immunohistochemical diagnosis of splenic lymphoma with atypical clinical presentation: a case report. Rev Bras Cancerol. 2021;67(4):e-171432. DOI: 10.32635/2176-9745.RBC.2021v67n4.1432.

Motta Ramírez GA, Montes Salcedo KE, Martínez Utrera MJ, López-Ramírez MA, Pereyra-Talamantes A, Ontiveros-Rodríguez A et al. The spleen: cemetery of leukocytes and radiological knowledge. Part three. Anales de Radiología México. 2016;15(3):222-237. https://www.analesderadiologiamexico.com/previos/ARM%202016%20Vol.%2015/ARM_16_15_3_Julio-Septiembre/arm_16_15_3_222-237.pdf.

Pascual-Escribano P, Oliva-Ibarz J, Selva-Talón D, Codó-Tarraubella X, Renobales-Barandiarán N, Di-Muro A, Bagué-Rosell S, Hernández-Jover D. Angiosarcomas: Un tumor poco frecuente. Hallazgos radiológicos y correlación anátomo-patológica. SERAM. 2024;1(1). https://piper.espacio-seram.com/index.php/seram/article/view/10329.

Karlo CA, Stolzmann P, Do RK, Alkadhi H. Computed tomography of the spleen: how to interpret the hypodense lesion. Insights Imaging. 2013;4(1):65-76. DOI: 10.1007/s13244-012-0202-z.

Verge J, Albiol J, Navas M, Martín C. Primary angiosarcoma of the spleen with liver metastases. Case report and literature review. Cir Esp. 2005 Jul;78(1):50-2. Spanish. DOI: 10.1016/s0009-739x(05)70884-8.

Sparrer D, Blazquez R, Keli F, et al. Primary and secondary metastatic dissemination: multiple routes to cancer-related death. Mol Cancer. 2025;24(21):203. DOI: 10.1186/s12943-025-02389-5.

Gaballah A, Jensen C, Palmquist S, Pickhardt P, Duran A, Duran A, Broering G, et al. Angiosarcoma: clinical and imaging features from head to toe. Br J Radiol. 2017;90(1075):20170039. DOI: 10.1259/bjr.20170039.

Samargandi R. Etiology, Pathogenesis, and management of angiosarcoma associated with implants and foreign body: clinical cases and research updates. Medicine (Baltimore). 2024;103(18):e37932. DOI: 10.1097/md.0000000000037932.

Manjee K, Sullivan M. Educational case: radiation-associated angiosarcoma in patients with breast cancer. Acad Pathol. 2020;7:2374289520912499. DOI: 10.1177/2374289520912499.

Hamid KS, Rodriguez JA, Laimore TC. Primary splenic angiosarcoma. JSLS. 2010;14(3):431-5. DOI: 10.4293/108680810x12924466006521.

Bhaludin BN, Thway K, Adejolu M, Renn A, Kelly-Morland C, Fisher C, et al. Imaging features of primary sites and metastatic patterns of angiosarcoma. Insights Imaging. 2021;12(1):189. DOI: 10.1186/s13244-021-01129-9.

Corvino A, Granata V, Tafuri D, Cocco G, Catalano O. Incidental focal spleen lesions: integrated imaging and pattern recognition approach to the differential diagnosis. Diagnostics (Basel). 2023;13(15):2536. DOI: 10.3390/diagnostics13152536.

Badiani R, Schaller G, Jain K, Swamy R, Gupta S. Angiosarcoma of the spleen presenting as spontaneous splenic rupture: a rare case report and review of the literature. Int J Surg Case Rep. 2013;4(9):765-766. DOI: 10.1016/j.ijscr.2013.06.007.

Hasiloglu ZI, Metin DY, Ozbayrak M, Havan N. Locally invasive primary splenic angiosarcoma. Eurasian J Med. 2010;42(3):160-3. DOI: 10.5152/eajm.2010.44.

Qi R, Yu JQ, Xu H, Zhou XP, Li XM. Primary angiosarcoma of the spleen as depicted on computed tomography. Clin Imaging. 2012;36(5):619-622. DOI: 10.1016/j.clinimag.2011.12.016.

Batouli A, Fairbrother SW, Silverman JF, Muniz M, Taylor KB, Weilnick MA, et al. Primary splenic angiosarcoma: clinical and imaging manifestations of this rare aggressive neoplasm. Curr Probl Diagn Radiol. 2016;45(4):284-7. DOI: 10.1067/j.cpradiol.2015.07.004.

Duan YF, Jiang Y, Wu CX, Zhu F. Spontaneous rupture splenic angiosarcoma: a case report and literature review. World J Surg Oncol. 2013;11:53. DOI: 10.1186/1477-7819-11-53.

Downloads

Published

2026-06-15

How to Cite

Iñiguez Guzmán, C. A., & Vintimilla Contreras, J. S. (2026). Primary Splenic Angiosarcoma with Retroperitoneal Invasion: A Case Report: Angiosarcoma esplénico primario con invasión retroperitoneal: reporte de caso. Peruvian Journal of Health Care and Global Health, 10(2). https://doi.org/10.22258/hgh.v10i2.431

Issue

Vol. 10 No. 2 (2026)

Section

Case reports

License

Copyright (c) 2026 Carlos Alfredo Iñiguez Guzmán, Joel Sebastian Vintimilla Contreras

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  • The authors will retain their copyright and will guarantee to the journal right of first publication of their work, which will simultaneously be under a Creative Commons Attribution 4.0 License that allows third parties to share the work whenever attribuying their author and first publication in this journal.
  • The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
  • Authors are permitted and encouraged to post online a pre-publication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (see The Effect of Open Access).