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Case Reports
. 2021 May 24:9:2050313X211016992.
doi: 10.1177/2050313X211016992. eCollection 2021.

A unique case of splenic tumor exhibiting a serous carcinoma phenotype

Keisuke Kawashima  1 , Yusuke Kito  1 , Koya Tochii  2 , Masaki Kimura  2 , Taro Takeda  3 , Takafumi Sekino  2 , Tsuneko Ikeda  1 , Tamotsu Takeuchi  4
Affiliations
Case Reports

A unique case of splenic tumor exhibiting a serous carcinoma phenotype

Keisuke Kawashima et al. SAGE Open Med Case Rep. .

Abstract

The spleen has no epithelial element; thus, primary carcinoma of the spleen is quite rare. We present the case of a patient with serous carcinoma of the spleen. A 76-year-old woman with no significant medical history presented with a huge lesion in the spleen. Except this lesion, clinical examination, including imaging examination, revealed no remarkable findings. She underwent excision of the spleen for treatment and diagnosis. Postoperative pathological examination revealed neoplastic cells with pleomorphic and hyperchromatic nuclei, prominent nucleoli, and frequent mitotic activity. The neoplastic cells exhibited a papillary pattern with psammoma bodies. Immunohistochemistry showed positivity for cytokeratin 7, PAX-8, WT-1, p16, p53, and Ber-EP4 and negativity for cytokeratin 20, thyroid transcription factor-1, carcinoembryonic antigen, CD10, estrogen receptor, calretinin, D2-40, intelectin-1, and sialylated HEG1. We inferred that this tumor was a primary splenic serous carcinoma. Serous tubal intraepithelial carcinoma is the plausible origin of most pelvic serous carcinomas. However, the origin of serous carcinoma of the spleen remains unknown. We speculated that endosalpingiosis might be the origin of the tumor.

Keywords: Spleen; immunohistochemistry; serous carcinoma; splenectomy; splenic adenocarcinoma.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Contrast-enhanced computed tomography showing a lobulated hypodense mass in the spleen: (a) transaxial image; (b) coronal image.
Figure 2.
Figure 2.
(a) Whole-body 18F-fluorodeoxyglucose positron emission tomography demonstrating high tracer accumulation only in the spleen. (b) Fused positron emission tomography/computed tomography images of the cross section of the spleen showed hot spot (maximum standard uptake value = 5.5).
Figure 3.
Figure 3.
Macroscopic view of the resected spleen. A white-gray, well-defined mass containing necrotic areas, 130 × 120 × 90 mm in size, showing an expansive growth pattern in the spleen.
Figure 4.
Figure 4.
Hematoxylin and eosin staining of the splenic tumor neoplastic cells showing a papillary pattern with necrotic tissue and a psammoma body (arrow) (a, ×100). Pleomorphic and hyperchromatic nuclei were observed (b, ×200).
Figure 5.
Figure 5.
Immunohistochemical staining of the tumor cells for cytokeratin 7 (a, ×200), cytokeratin 20 (b, ×200), PAX-8 (c, ×200), WT-1 (d, ×200), p53 (e, ×200), and Ber-EP4 (f, ×200).
See this image and copyright information in PMC

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