Reappraisal of surgical decision-making in patients with splenic sclerosing angiomatoid nodular transformation:Case series and literature review  

作　　者：Hao Tseng Cheng-Maw Ho Yu-Wen Tien 

机构地区：[1]School of Medicine,National Taiwan University College of Medicine [2]Department of Medical Education,and Department of Surgery,National Taiwan University Hospital [3]Department of Surgery,National Taiwan University Hospital and National Taiwan University College of Medicine

出　　处：《World Journal of Gastrointestinal Surgery》2021年第8期848-858,共11页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Many clinicians and surgeons are unfamiliar with the sclerosing angiomatoid nodular transformation(SANT),which is gaining recognition as a benign splenic tumor.We challenge that SANT is rare and whether surgical intervention could be avoided through critical imaging review.AIM To evaluate the incidence of SANT among splenic tumors and the decisionmaking process of SANT management.METHODS Twenty hospitalized patients who underwent splenectomy in 2018 and 2019 in a tertiary university hospital were retrospectively reviewed,and their data on imaging,diagnosis,surgical indications,and courses were recorded.All pathology results were confirmed by pathologist.Discriminative features differentiating SANT from other non-SANT splenic tumors were descriptively analyzed in this case series.RESULTS Fourteen out of 20 patients who underwent splenectomy had splenic tumors,including 3 SANTs(21%splenic tumors),6 non-SANT benign lesions(43%),2 metastatic tumors,and 3 lymphomas.Hypointensity on T2-weighted magnetic resonance imaging(MRI),spoke wheel enhancing pattern in contrasted computed tomography or MRI,and cold spot(low fluorodeoxyglucose uptake)in positron emission tomography(PET)scan helped establish the diagnosis of SANT.Lymphoma,presenting with a hot spot on the PET scan were differentiated from SANT.Surgical indications were reformatted for splenic tumors.Splenectomy need not be performed in patients with typical imaging features of SANT.CONCLUSION SANT is not a rare disease entity in clinical practice.Splenectomy should not be routinely indicated as the only management option for SANT with typical imaging features.

关 键 词：Splenic tumor DIAGNOSIS Surgical decision-making Sclerosing angiomatoid nodular transformation Retrospective study 

分 类 号：R733.2[医药卫生—肿瘤]