Journal of Leukemia
Open Access

Primary Splenic Cancer Characteristics and Prognosis

David Stephen^{* *}Correspondence: David Stephen, Department of Oncology, Adama Science and Technology University, Adama, Ethiopia, Email:

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About the Study

Primary splenic neoplasms are uncommon in general surgical pathology, but when they do occur, they may necessitate splenectomy for diagnosis or therapy. The delicate spleen, buried in its recess in the left upper quadrant, is always an intriguing and tough task for the surgeon, and the presence of a tumor makes it much more difficult.

Clinical features-diagnostic tests

There are no consistent clinical characteristics that can be applied to the whole group of splenic tumours. The most common finding is splenomegaly. There may also be discomfort, soreness, or tenderness in the upper quadrant. Depending on the location and extent of the lesion, anemia, granulocytopenia, and thrombocytopenia may occur.

Splenomegaly may be accompanied by symptoms of systemic involvement such as fever, cachexia, and pleural infusion in the event of cancer. Massive splenomegaly (above 3000 grams) can induce neighboring viscera displacement and pressure, resulting in dyspnea, shoulder discomfort, and constipation, among other symptoms. The Computed Tomography (CT) scan is the most useful imaging test available today. Following surgical removal, histological testing appears to be the most accurate method of diagnosis.

Lymphangioma

Lymphangioma of the spleen is even less frequent than hemangioma of the liver, with clinical presentations ranging from minor incidental observations to massive, symptomatic multicystic splenic tumours needing surgery. The latter is observed in association with disseminated lymphangiomatosis, a pediatric condition in which the lymphangiomatous process spreads to other places or organs, such as the bone, soft tissue, or viscera. Single or several splenic lymphangiomas are possible. Small multicystic, subcapsular proliferations that are difficult to identify from haemangioma or mesothelial cysts are the most common. Unlike splenic haemangiomas, which can appear anywhere in the spleen, splenic lymphangiomas are commonly seen in the subcapsular or trabecular portions of the spleen, where splenic lymphatics are generally found. Many mesothelial cysts were formerly misdiagnosed as lymphangiomas, until detailed immunophenotypic study of these lesions revealed that the cystic lining cells were of mesothelial rather than lymphatic origin. The neoplasm is made up of thin-walled cystic formations of different sizes that are bordered by flat endothelium and filled with a pink eosinophilic proteinacious substance that is devoid of red blood cells. Focuses of plump lining cells, frequently generating remarkable papillary projections, may usually be detected on close scrutiny. It's important to separate these papillary regions from angiosarcoma with caution. Because there is presently no way to tell the difference between lymphangiosarcoma and angiosarcoma, these instances are best categorized as angiosarcoma.

Metastatic tumors involving the spleen

Splenic metastases are quite uncommon. Berge found a 7.1 percent overall incidence of splenic involvement in 7165 postmortem patients with different malignancies, and a 4.4 percent and 1.6 percent incidence of splenic metastasis from colon and rectal carcinomas, respectively. The rarity of solitary cancer metastases has been attributed to anatomical, histological, and functional characteristics of the spleen. Breast, lung, and melanomas are among the most common carcinomas of origin. It's possible to find direct extension from retroperitoneal tumours and pancreatic cancer. Almost all original cancers have been found to be able to metastasis to the spleen, and splenic metastases are most often associated with disseminated illness. The majority of cases are asymptomatic, and the diagnosis is generally made during the surgical follow-up phase of colorectal cancer patients using imaging investigations such as abdominal Ultrasound (US) or Computed Tomography (CT). Splenomegaly, left pleural effusion, and spontaneous rupture have all been documented, though.

Conclusion

Splenic neoplasms are uncommon, and diagnosing them can be difficult. The majorities of them are asymptomatic and are discovered by chance following splenectomies. The delicate spleen, along with the malignant potential of a few splenic neoplasms, necessitates rapid and correct diagnosis in more than a few individuals.