Could hemangioma and enlarged spleen mean angiosarcoma?

Question

Hello doctor,

I had an incidental low-density mass, found on my spleen during a CT scan for possible kidney stones. A recommended follow up ultrasound with doppler showed a 4.3 X 4.7 X 4.8 cm ill-defined heterogeneous hyperechoic mass. The mass showed blood flow around the peripheral. The report said it might be a splenic hemangioma, but that other benign or malignant lesions or metastatic focus cannot be entirely excluded. My spleen is mildly enlarged for about 16 cm. All of my blood work came back normal, except one for inflammation. I have a followup CT scan with contrast (drink) scheduled. I am extremely anxious and scared if it is splenic angiosarcoma. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

As you mentioned that it might be splenic haemangioma as per USG (ultrasonography) with Doppler, let me relieve you by stating that it is one of the rarest condition affecting the spleen, one of the commonest benign condition and has no malignant potential. So do not fear about Angiosarcoma.

Though it is mostly asymptomatic may present with abdominal discomfort (pain), breathing difficulty, hemorrhage (spontaneous rupture), or diarrhea. If symptomatic splenectomy is the choice of treatment, the size of haemangioma ranges from 0.3 to 7 cm. Your haemangioma size ranges in the medium range, and this has a very low growing potential.

Kindly review with CECT (contrast-enhanced computed tomography) and MRI (magnetic resonance imaging) or nuclear imaging. These investigations have more sensitivity and specificity to diagnose splenic haemangiomas.

As you are asymptomatic and I have already mentioned that splenic haemangiomas have very slow growing potential, so no need for surgery at present. Taking asymptomatic CECT yearly once to keep track of the size of the haemangioma will be essential. Once again, let me assure you that it does not have malignant potential.