Laparoscopic splenectomy for sclerosing angiomatoid nodular transformation of the spleen: Report a case

Toshikatsu Nitta; Kohei Horiguchi; Masatsugu Ishii; Masataka Taki; Ryutaro Kubo; Atsushi Takeshita

doi:10.1016/j.ijscr.2024.109699

Laparoscopic splenectomy for sclerosing angiomatoid nodular transformation of the spleen: Report a case

Int J Surg Case Rep. 2024 May 3:119:109699. doi: 10.1016/j.ijscr.2024.109699. Online ahead of print.

Authors

Toshikatsu Nitta¹, Kohei Horiguchi², Masatsugu Ishii², Masataka Taki², Ryutaro Kubo², Atsushi Takeshita³

Affiliations

¹ Division of Surgery Gastroenterological Center, Medico Shunju Shiroyama Hospital, Osaka, Japan. Electronic address: nitta@shiroyama-hsp.or.jp.
² Division of Surgery Gastroenterological Center, Medico Shunju Shiroyama Hospital, Osaka, Japan.
³ Department of Pathology Moriguchi Keijinkai Hospital, Japan.

Abstract

Introduction and importance: Sclerosing angiomatoid nodular transformation (SANT) of the spleen is an extremely rare benign lesion.

Case presentation: Here, we describe the case of a 52-year-woman who was diagnosed with sclerosing angiomatoid nodular transformation of the spleen. Abdominal contrast-enhanced CT revealed a solid lesion in the splenic hilum that was slowly enhanced between the portal venous and equilibrium phases incidentally. Fluorodeoxyglucose positron emission tomography (FDG-PET) revealed FDG accumulation within the mass, with a maximum standardized uptake value (SUVmax) of 2.57. Based on these findings, the patient was scheduled for laparoscopic splenectomy. The total operating time was 193 min, and the intraoperative blood loss was 20 ml. The resected specimen was 9.0 × 8.4 × 5.6 cm and dark brown in colour with a large central stellate fibrotic scar.

Clinical discussion: Pathological examination revealed nodular angioma lesions and the proliferation of fibrotic interstices and inflammatory cells. We could diagnose the SANT by the only HE staining without Immunohistochemical staining.

Conclusion: Although SANT is a rare benign lesion, which is difficult to definitively diagnose based on preoperative imaging findings alone, it should be considered in cases of solitary splenic lesions, and we recommend performing LS and subsequent histological examination for the diagnosis of this disease.

Keywords: Laparoscopic splenectomy; SANT; Sclerosing angiomatoid nodular transformation.

Publication types

Case Reports