Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.103
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
Processing time: 80 Days and 4.2 Hours
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.
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.
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.