Case Report
Splenic angiosarcoma metastasis to the brain

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Abstract

Angiosarcoma is a rare primary non-haematolymphoid malignant neoplasm of the spleen. This neoplastic process has a poor prognosis, with disease usually widespread by the time of presentation. In the literature there has been only six case reports of cerebral metastasis from splenic angiosarcomas. We report a 61-year-old woman who presented with a right occipital metastasis of a splenic angiosarcoma, 5 years after initial diagnosis, treated by stereotactic occipital craniotomy and resection of metastasis.

Introduction

Primary splenic angiosarcoma is very rare. This neoplastic process has a high metastatic rate and dismal prognosis. The literature contains only six cases of disseminated disease with brain metastases, with mean survival of 6.6 months from initial diagnosis,[1], [2] all confirmed on autopsy. To our knowledge, we present the first patient with a cerebral metastasis of a splenic angiosarcoma treated by craniotomy and resection of metastasis.

Section snippets

Case report

A 61-year-old Caucasian woman presented to our neurosurgical unit. The patient was diagnosed with splenic angiosarcoma 5 years prior to presentation and underwent a splenectomy. Six months prior to her first neurosurgical visit, she was found to have pulmonary metastasis, for which she underwent chemotherapy. She also developed right hip pain and a sacral lesion was found. Three months later, she developed blurring of visual acuity and intermittent flashing lights in her left visual field

Discussion

Angiosarcomas are uncommon malignant neoplasms characterized by rapidly proliferating, extensively infiltrating anaplastic cells. They are derived from endothelial cells of arteries, veins or lymphatic channels.3

The macroscopic appearance of splenic angiosarcoma varies from one to several nodular, well-circumscribed masses to large ill-defined regions of haemorrhage and necrosis.2 All angiosarcomas have similar microscopic findings, with vascular spaces more or less obvious and lined by tumour

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