A rare case of sclerosing angiomatoid nodular transformation of spleen: A case report

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INTRODUCTION AND IMPORTANCE: Sclerosing angiomatoid nodular transformation of the spleen is a rare benign vascular lesion arising from red pulp of spleen with unknown etiopathogenesis. It is a non-neoplastic condition that affects the spleen only; not described in other sites except one case reported in adrenal gland. Epidemiologically it has slight female predilection. It is a very rare ailment where the present finding is very crucial in the management of similar cases so far. CASE PRESENTATION: A 31 years old female patient presented with left flank pain and constipation of 01 year duration. An abdominopelvic CT scan showed a hypodense mass in the left upper quadrant of abdomen just anterior to inferior pole of spleen with the conclusion of mesenteric mass likely gastrointestinal stromal tumor. Finally, it was decided and exploratory laparotomy was done and the surgeon identified the mass in the inferior pole of spleen and total splenectomy was done, and the specimen is sent for pathologic evaluation. The final histopathologic diagnosis became sclerosing angiomatoid nodular transformation of spleen with the classic microscopic findings of multiple confluent angiomatoid nodules surrounded by variable concentric fibrosclerotic stroma. CLINICAL DISCUSSION: Sclerosing angiomatoid nodular transformation of spleen is a benign incidentally identified vascular condition of red pulp in the majority of cases. Preoperative diagnosis is not easy since it is difficult to obtain the tissue from the spleen for pathological study. Recently, splenectomy has become the more standard procedure for the spleen for both diagnosis and treatment with no recurrence reported after splenectomy.

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