Sclerosing Angiomatoid Nodular Transformation of the Spleen: Lessons from a Rare Case and Review of the Literature

Nomura, Ryohei; Takeuchi, Hiromi; Katayose, Yu; Nakayama, Fumie; Iwama, Noriyuki; Furihata, Makoto

doi:10.2169/internalmedicine.1948-18

Cited by 18 publications

(14 citation statements)

References 18 publications

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“…There is a slight female predominance. The mean age in the study population was 44 years, correlating well with other, not included reviews [ 2 3 ]. SANT is almost exclusively described in the spleen, except for one reported at the adrenal gland [ 4 ].…”

Section: Characteristicssupporting

confidence: 76%

Sclerosing Angiomatoid Nodular Transformation of the Spleen: A Diagnostic Conundrum

Eede

Voorde

Vanhoenacker³

et al. 2022

Journal of the Belgian Society of Radiology

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A splenic lesion often represents a diagnostic challenge due to relative scarcity and the broad differential diagnosis. Sclerosing Angiomatoid Nodular Transformation (SANT) of the spleen is usually encountered only incidentally. Although benign, patients with SANT often receive splenectomy, due to its rarity, diagnostic uncertainty and sometimes intimidating imaging morphology and size. Imaging features on computed tomography, magnetic resonance and positron emission tomography have a high diagnostic value for SANT and help differentiate this entity from other splenic lesions. When the imaging parameters are matched with core needle biopsy tissue analysis, further watchful waiting can be recommended in order to avoid splenectomy.

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Section: Characteristicssupporting

confidence: 76%

Sclerosing Angiomatoid Nodular Transformation of the Spleen: A Diagnostic Conundrum

Eede

Voorde

Vanhoenacker³

et al. 2022

Journal of the Belgian Society of Radiology

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“…Internodular stroma show myxoid to dense fibrous tissue with scattered plump myofibroblasts, lymphoplasma cells and siderophages. 11 These findings indicate gradual progression of angiomatoid nodules to collagenized fibres. Few studies suggest that the fusiform cells in the nodules are considered to be myofibroblasts with expression of SMA found to be inside and around the angiomatoid nodules extending to the junction between the lesion and splenic tissue and infiltrated the nodules and residual splenic tissue.…”

Section: Discussionmentioning

confidence: 89%

Sclerosing angiomatoid nodular transformation of spleen: an uncommon benign lesion of spleen

Sekaran¹,

Reddy²,

Shetty

et al. 2021

Int J Res Med Sci

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SANT (sclerosing angiomatoid nodular transformation) is a rare benign vascular tumour of spleen. SANT can mimic benign and malignant conditions of spleen. There are no definite radiological features. It has characteristic histopathology and immunohistochemistry findings which help us to differentiate it from other angiomatoid and tumor-like lesions. Splenectomy is the treatment of choice as it is diagnostic and therapeutic at the same time. We present a case of 22 years female with left upper quadrant pain since, 2 months. Magnetic Resonance Imaging revealed well-defined hypodense mass measuring 6.3×6.1×5.8cm in the spleen, with provisional diagnosis of hemangioma. Laproscopic splenectomy was done and a diagnosis of SANT was made on histology and immunohistochemistry. This case shows us that SANT should be considered in the differential diagnosis of splenic solid lesions.

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“…The curative treatment for SANT is splenectomy [ 46 , [48] , [49] , [50] , [51] , [52] , [53] , [55] , [56] , [57] , [58] , [59] , [60] ]. Open splenectomy or minimally invasive splenectomy are both options for surgical treatment [ [62] , [63] , [64] , [65] , [66] , [67] , [68] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] ]. In recent years, minimally invasive surgery such as robotic or laparoscopic splenectomy has become more popular due to a shorter hospital stay, less postoperative abdominal pain, and an early return to normal activity [ 18 , [63] , [64] , [65] , 78 ].…”

Section: Discussionmentioning

confidence: 99%

Sclerosing angiomatoid nodular transformation presenting with thrombocytopenia after laparoscopic splenectomy - Case report and systematic review of 230 patients

Aziret

Yılmaz

Kalpakci

et al. 2020

Annals of Medicine and Surgery

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Background Sclerosing angiomatoid vascular transformation (SANT) is a rare vascular disease of the spleen, which is difficult to diagnose due to its pre-intervention appearance of malignancy. Case Report: An 85-year-old male was transferred to our clinic for thrombocytopenia and splenic mass. A contrast enhanced abdominal CT and MRI showed nodular lesions, the largest 50mm in diameter, and several areas of heterogeneous contrast field involvement in the spleen parenchyma. Laparoscopic splenectomy was performed with normal range of platelet level. The patient's postoperative course was uneventful and he was discharged on the 6th postoperative day. Histopathology revealed SANT. The patient is now in the 18 th month of remission with platelet levels within normal range and with no recurrence. Results Between 2004 and April 2020, a total of 230 SANT patients who underwent laparoscopic or open splenectomy or biopsy were reported in the literature. Most patients were female (52.1%), and the median age was 46 years (9 weeks-85 years). Most patients were asymptomatic (56%). Open splenectomy was performed on 166 patients (72.1%),laparoscopic splenectomy on 35 patients (15.2%) and laparoscopic partial splenectomy on 15 patients (6.5%). The median operation time and spleen weight were 143 minutes (88-213) and 260gr (68-2,720), respectively. Median follow-up time was 12 months (0-166). No recurrence was seen in patients undergoing total splenectomy. Conclusion SANT is an unusual disease of the spleen. In the light of this systematic review, a minimally invasive method for total or partial splenectomy,specifically laparoscopy, can be preferred as the treatment of choice.

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Sclerosing Angiomatoid Nodular Transformation of the Spleen: Lessons from a Rare Case and Review of the Literature

Cited by 18 publications

References 18 publications

Sclerosing Angiomatoid Nodular Transformation of the Spleen: A Diagnostic Conundrum

Sclerosing Angiomatoid Nodular Transformation of the Spleen: A Diagnostic Conundrum

Sclerosing angiomatoid nodular transformation of spleen: an uncommon benign lesion of spleen

Sclerosing angiomatoid nodular transformation presenting with thrombocytopenia after laparoscopic splenectomy - Case report and systematic review of 230 patients

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