Speaker Credentials
MDIII
College
College of Allopathic Medicine
Medical Specialty
General Surgery
Format
Poster
Start Date
November 2024
End Date
November 2024
Track
4
Abstract
Introduction: Splenic angiosarcoma is an uncommon, malignant neoplasm of vascular endothelial origin. Given its unique nature and rupture potential, we present a case of perforated splenic angiosarcoma. Case Description: A 79 year-old female with a history of vocal cord paralysis, recurrent laryngeal nerve palsy, and thyroidectomy presented for a second time with stridor and worsening shortness of breath. Due to desaturation and bradycardia, unsuccessful intubation led to a tracheostomy and ICU transfer. She stabilized and showed no major complications for seven days. On discharge day, the patient became diaphoretic, pale, and non-responsive, prompting a rapid response and code blue. Major transfusion protocol (MTP) was activated. CTA chest and abdomen revealed hemoperitoneum and splenic laceration with active extravasation, alongside a pulmonary embolism. Despite resuscitative efforts, there was hemodynamic instablity for which the patient underwent exploratory laparotomy. 4 liters of blood were evacuated, and active bleeding was noted at the splenic vein and artery, along with a lobulated splenic mass. Pathology revealed a 2.5 cm perforated splenic angiosarcoma. Discussion: Primary splenic angiosarcoma is exceedingly rare, with about 300-400 cases documented and an incidence rate of 0.14–0.25 cases per year per million individuals. It has a grim prognosis, with about 30% of cases diagnosed after splenectomy for spontaneous rupture. Symptoms typically include abdominal pain (75%), fatigue, weight loss, and splenomegaly. Notably, one-third of cases may show organ rupture as the initial manifestation. Conclusion: This case highlights the life-threatening complications of splenic angiosarcoma, emphasizing the need for increased clinician awareness in patients with sudden distress.
Hemodynamic Collapse from Perforated Splenic Angiosarcoma: A Rare Case
Introduction: Splenic angiosarcoma is an uncommon, malignant neoplasm of vascular endothelial origin. Given its unique nature and rupture potential, we present a case of perforated splenic angiosarcoma. Case Description: A 79 year-old female with a history of vocal cord paralysis, recurrent laryngeal nerve palsy, and thyroidectomy presented for a second time with stridor and worsening shortness of breath. Due to desaturation and bradycardia, unsuccessful intubation led to a tracheostomy and ICU transfer. She stabilized and showed no major complications for seven days. On discharge day, the patient became diaphoretic, pale, and non-responsive, prompting a rapid response and code blue. Major transfusion protocol (MTP) was activated. CTA chest and abdomen revealed hemoperitoneum and splenic laceration with active extravasation, alongside a pulmonary embolism. Despite resuscitative efforts, there was hemodynamic instablity for which the patient underwent exploratory laparotomy. 4 liters of blood were evacuated, and active bleeding was noted at the splenic vein and artery, along with a lobulated splenic mass. Pathology revealed a 2.5 cm perforated splenic angiosarcoma. Discussion: Primary splenic angiosarcoma is exceedingly rare, with about 300-400 cases documented and an incidence rate of 0.14–0.25 cases per year per million individuals. It has a grim prognosis, with about 30% of cases diagnosed after splenectomy for spontaneous rupture. Symptoms typically include abdominal pain (75%), fatigue, weight loss, and splenomegaly. Notably, one-third of cases may show organ rupture as the initial manifestation. Conclusion: This case highlights the life-threatening complications of splenic angiosarcoma, emphasizing the need for increased clinician awareness in patients with sudden distress.