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Early detection and integral resection are keys to extend survival in patients suffered from primary angiosarcoma of the spleen: A care-compliant case report and literature review.

Abstract Primary angiosarcoma of the spleen (PAS) is a very rare malignant neoplasm that originates from endothelial cells of the splenic blood vessels. Without typical clinical presentations and specific radiological features, PAS is very difficult to be early identified and 1-year mortality is extremely high. Late detection and spleen rupture are considered as the most important risk factors for early metastasis.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29384853
OWN - NLM
STAT- MEDLINE
DCOM- 20180213
LR  - 20180213
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 5
DP  - 2018 Feb
TI  - Early detection and integral resection are keys to extend survival in patients
      suffered from primary angiosarcoma of the spleen: A care-compliant case report
      and literature review.
PG  - e9718
LID - 10.1097/MD.0000000000009718 [doi]
AB  - RATIONALE: Primary angiosarcoma of the spleen (PAS) is a very rare malignant
      neoplasm that originates from endothelial cells of the splenic blood vessels.
      Without typical clinical presentations and specific radiological features, PAS is
      very difficult to be early identified and 1-year mortality is extremely high.
      Late detection and spleen rupture are considered as the most important risk
      factors for early metastasis. PATIENT CONCERNS: Without any obvious symptom, a
      35-year-old woman was admitted with splenic neoplasm that was accidentally
      discovered through a routine physical examination. DIAGNOSES: The patient was
      first diagnosed as lymphoma by laboratory tests and imaging studies, but changed 
      to PAS by histological examinations after the surgery. INTERVENTIONS: After
      careful preoperational assessment, a laparoscopic-assisted splenectomy was
      scrutinously performed and the entire spleen was removed without any rupture.
      OUTCOMES: The postoperative followed-up was uneventful until 3 years later, when 
      she sought medical attention due to persisting back pain. Bone metastasis was
      consequently identified and the symptom was quickly alleviated after radiation
      therapy. However, intra-abdominal metastases leading to intestinal obstruction
      occurred 4.5 years after surgery. Following short palliative treatment, the
      patient passed away 4 years and 9 months after the operation due to multiple
      organ failure. LESSONS: PAS is an uncommon and aggressive splenic disease. Once
      suspected, PAS require prompt and precise surgical procedures to remove the tumor
      origin. Laparoscopic-assisted splenectomy was technically feasible and
      therapeutically harmless for PAS treatment compared with open surgery as long as 
      the spleen was removed intact. However, more evaluation of this option will be
      needed due to limited experience by now. Early discovery, precautious plan,
      meticulous operation, close follow-up, and comprehensive treatment may
      significantly prolong the living period of this fatal disease.
FAU - Chen, Xuchun
AU  - Chen X
AD  - Department of General Surgery, First Affiliated Hospital, China Medical
      University, Shenyang, Liaoning Province, China.
FAU - Li, Hong
AU  - Li H
FAU - Wang, Fengshan
AU  - Wang F
FAU - Liu, Hao
AU  - Liu H
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adult
MH  - Diagnosis, Differential
MH  - Early Diagnosis
MH  - Fatal Outcome
MH  - Female
MH  - Hemangiosarcoma/*diagnosis/pathology/radiotherapy/*surgery
MH  - Humans
MH  - Incidental Findings
MH  - Lymphoma/diagnosis
MH  - Splenic Neoplasms/*diagnosis/pathology/radiotherapy/*surgery
EDAT- 2018/02/01 06:00
MHDA- 2018/02/14 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/14 06:00 [medline]
AID - 10.1097/MD.0000000000009718 [doi]
AID - 00005792-201802020-00015 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(5):e9718. doi: 10.1097/MD.0000000000009718.