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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Sclerosing angiomatoid nodular transformation of the spleen, a rare cause for splenectomy: Two case reports
Sophia Chikhladze, Ann-Kathrin Lederer, Stefan Fichtner-Feigl, Uwe A Wittel, Martin Werner, Konrad Aumann
Sophia Chikhladze, Ann-Kathrin Lederer, Stefan Fichtner-Feigl, Uwe A Wittel, Department of General and Visceral Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
Ann-Kathrin Lederer, Center for Complementary Medicine, Department of Infection Prevention and Hospital Epidemiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
Martin Werner, Konrad Aumann, Institute of Surgical Pathology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
Author contributions: Chikhladze S and Aumann K initiated the study and collected the cases; Wittel UA, Fichtner-Feigl S, and Chikhladze S performed the surgery; Werner M and Aumann K performed histological evaluations; Lederer AK wrote the manuscript with the help of Chikhladze S and Aumann K; Wittel UA, Fichtner-Feigl S, and Werner M revised the manuscript.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sophia Chikhladze, MD, Surgeon, Department of General and Visceral Surgery, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, Freiburg 79106, Germany. sophia.chikhladze@uniklinik-freiburg.de
Received: October 18, 2019
Peer-review started: October 18, 2019
First decision: November 4, 2019
Revised: November 12, 2019
Accepted: November 20, 2019
Article in press: November 20, 2019
Published online: January 6, 2020
BACKGROUND
Sclerosing angiomatoid nodular transformation (SANT) is a rare benign disease of the spleen with unknown origin. Clinical symptoms are inhomogeneous, and suspicious splenic lesion often found incidentally, leading to splenectomy, as malignancy cannot securely be ruled out. Diagnosis is made histologically after resection.
CASE SUMMARY
Two cases of German, white, non-smoking, and non-drinking patients of normal weight are presented. The first one is a 26-year-old man without medical history who was exhibiting an undesired weight loss of 10 kg and recurring vomiting for about 18 mo. The second one is a 65-year-old woman with hypertension who had previously undergone gynecological surgery, suffering from a lasting feeling of abdominal fullness. Both showed radiologically an inhomogeneous splenic lesion leading to splenectomy approximately 6 and 9 wk after surgical presentation. Both diagnoses of SANT were made histologically. Follow-up went well, and both were treated according to the recommendation for asplenic patients.
CONCLUSION
SANT is a rare cause of splenectomy and an incidental histological finding. Further research should focus on clinical and radiological diagnosis of SANT as well as on treatment of patients with asymptomatic and small findings.
Core tip: We are presenting two cases of clinical evident sclerosing angiomatoid nodular transformation (SANT) and discuss the challenge of clinical non-operative management of small and asymptomatic splenic lesions. SANT is a benign vascular lesion of unknown etiology occurring in the spleen and does not appear to be related to age, gender, or pre-existing illnesses, although some reports have reported a higher frequency in women. SANT is an incidental histologically finding after splenectomy, and there is no guideline for treatment of SANT.
