Primary splenic hemangiosarcoma with liver metastasis and liver rupture after surgery: a rare case and literature review

Background Primary splenic angiosarcoma is an uncommon form of malignant splenic neoplasm that is characterized by rapid proliferation, significant invasiveness, and widespread metastases. However, the disease often presents with non-specific clinical manifestations, which can result in delayed diagnoses and misdiagnoses. Early diagnosis and intervention are therefore crucial for improving patient survival. Case Presentation This case report provides a comprehensive account of the diagnosis and treatment of a patient with primary splenic angiosarcoma, encompassing the entire clinical trajectory of the disease, including its onset, surgical intervention, postoperative chemotherapy, and ultimately, the patient's demise due to liver metastasis and liver rupture. The report is comprehensive and meticulously detailed, thus making it a valuable reference source. Prior to the onset of the disease, the patient exhibited no specific symptoms except for a decrease in platelets. CT and MRI played an important role in the diagnosis and evaluation of the disease. Surgical removal of the spleen, in conjunction with the formulation of an empirical chemotherapy regimen, enabled the patient to survive for a period of six months following surgery. However, the patient ultimately succumbed to a liver rupture. Conclusion Primary splenic angiosarcoma is a highly lethal condition, and prompt diagnosis and intervention are imperative for extending patients' survival. This case underscores the need for clinicians to exercise vigilance when encountering patients with prolonged thrombocytopenia, to utilize diverse diagnostic modalities to establish a differential diagnosis, and to endeavor to resect the tumour surgically while it is still small or, at the very least, before the spleen ruptures. Concurrently, there is an urgent need to develop new and more representative serum markers to facilitate differential diagnosis of the disease.