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Everything you need to know about Computed Tomography (CT) & CT Scanning

MDCT of the Spleen: Splenic Angiosarcoma


Primary tumors of the spleen are rare, and less frequent than metastases. Angiosarcoma is the most common primary, malignant, nonlymphoid tumor of the spleen with less than 100 cases reported in the literature. This tumor arises from vascular endothelial cells and patients with thorotrast exposure are at increased risk.

Patients typically present at 50-60 years old often with spenomegaly and abdominal pain. This neoplasm is aggressive and can cause an acute abdomen due to spontaneous splenic rupture leading to hemoperitoneum (33%).

On contrast enhanced CT the lesion may be single or multiple solid masses with variable enhancement patterns. Due to the aggressive nature of angiosarcomas, cystic and necrotic regions in the tumor are often demonstrated. Angiosarcoma has brisk focal intense enhancement with slower centripetal fill in with intravenous contrast. This pattern can be a clue to distinguishing this tumor from benign lesions of the spleen.

Commonly, metastasis has already occurred at time of initial diagnosis. 70% metastasize to the liver. Survival rate is 20% at six months.




© 1999-2021 Elliot K. Fishman, MD, FACR. All rights reserved.