Relapsing Haemothorax as an Unusual Presentation of Primary Angiosarcoma of the Spleen

  • Alba Bergas epartment of Internal Medicine, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Spain
  • Francesc Escrihuela-Vidal epartment of Internal Medicine, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Spain
  • Davinia Fernández Calvo Department of Pathology, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Spain
  • Olga Capdevila Pons Department of Internal Medicine, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Spain
  • Xavier Corbella Department of Internal Medicine, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute-IDIBELL, L’Hospitalet de Llobregat, Spain; School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain

Keywords

Spleen, angiosarcoma, haemothorax

Abstract

Spontaneous haemothorax (SH) is a rare subcategory of haemothorax that involves the accumulation of blood within the pleural space in the absence of trauma. SH especially occurs in middle-aged or elderly patients, but data are usually limited to case reports and case series. Coagulopathy, aneurysm or aortic dissection, Rendu-Osler-Weber syndrome and malignancy have to be considered among the causes of SH.
Aim: We describe a case of primary angiosarcoma of the spleen presenting as relapsing haemothorax.
Results: An 81-year-old woman was referred to our hospital because of a 2-month history of relapsing haemothorax after the performance of urgent splenectomy due to active bleeding from large spleen cysts. No evidence of neoplasm was seen after pathological examination of the spleen. On admission, left haemothorax and 2 new cystic masses in the thoracic wall were documented, both in close relation to the scars of previous surgery and chest tubes. After excision of 1 mass, histological examination revealed angiosarcoma, and a final diagnosis of primary angiosarcoma of the spleen with postsurgical metastatic dissemination to the thorax and pleura was made.
Conclusion: Primary angiosarcoma should be included in the differential diagnosis of haemorrhagic spleen cysts. Clinical diagnosis and management usually requires splenectomy, but it should be carefully planned in order to avoid local metastatic dissemination or haematogenous spread of the tumour.

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Published: 2020-10-29

Issue: Vol 8 No 1 (view)

Section: Articles

How to cite:
1.
Bergas A, Escrihuela-Vidal F, Fernández Calvo D, Capdevila Pons O, Corbella X. Relapsing Haemothorax as an Unusual Presentation of Primary Angiosarcoma of the Spleen. EJCRIM 2020;8 doi:10.12890/2020_001944.