The spleen is a soft, fist-sized organ situated in the upper-left abdomen, shielded by the ribcage. It primarily functions as a blood filter, removing old, damaged, or abnormal blood cells and recycling components like iron. As a major component of the immune system, it contains specialized white blood cells that identify and destroy pathogens. Tumors arising within the spleen are relatively rare but represent a serious health concern requiring prompt medical evaluation to determine the mass’s specific nature.
Recognizing the Signs
The presence of a spleen tumor often fails to produce noticeable symptoms, especially when the mass is small. When symptoms appear, they are frequently vague and can mimic less serious conditions. The most common indicator is an enlarged spleen, medically termed splenomegaly, which may cause a feeling of fullness (early satiety) after eating small amounts of food.
The enlarged organ can press on surrounding structures, causing discomfort or pain localized to the upper-left abdomen. Systemic signs often accompany tumor growth, including unexplained weight loss, persistent fatigue, and recurrent fevers or night sweats. Interference with the spleen’s blood filtering role can also cause anemia, easy bruising, or an increased susceptibility to infection.
Classifying Spleen Tumors
Spleen tumors are classified based on whether they are benign (non-cancerous) or malignant (cancerous), and whether they are primary (originating in the spleen) or secondary (metastatic). Benign tumors are the most frequently encountered splenic mass. The most common benign type is the hemangioma, a growth arising from blood vessels.
Other benign types include lymphangiomas, originating from lymphatic vessels, and hamartomas, composed of disorganized splenic tissue. Even though they are non-cancerous, large benign masses can cause pain, pressure on nearby organs, or a risk of rupture. Malignant tumors are less common but pose a severe threat due to their ability to invade tissue and metastasize.
The majority of malignant growths are lymphomas, originating from the spleen’s lymphatic tissue, particularly non-Hodgkin lymphoma. A rarer primary cancer is angiosarcoma, which develops from vascular cells. Primary splenic tumors are uncommon; more frequently, a malignant mass is secondary, having spread from cancer elsewhere in the body. Common primary tumors that spread to the spleen include cancers of the breast, lung, and malignant melanoma.
Diagnostic Methods
Diagnosis begins with a physical examination to check for an enlarged spleen. Initial blood work, such as a complete blood count, checks for abnormalities like anemia or unusual levels of white blood cells, suggesting splenic dysfunction. Imaging studies are then used to visualize the spleen and confirm the mass.
An abdominal ultrasound is often the first imaging tool used. Detailed cross-sectional imaging, such as Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans, helps determine the tumor’s size, location, and characteristics, and checks for cancer spread.
Definitive classification requires a tissue sample, usually obtained via a fine-needle biopsy for cellular analysis. However, due to the spleen’s highly vascular nature, percutaneous biopsy carries a risk of bleeding and is not always performed, especially if imaging strongly suggests a benign tumor. In some cases, diagnosis is confirmed only after surgical removal of the spleen.
Management and Treatment Pathways
Management depends heavily on whether the tumor is benign or malignant. For small, asymptomatic masses strongly suspected to be benign, watchful surveillance is implemented. This involves periodic imaging scans to monitor the mass over time. Intervention is reserved for benign tumors that grow rapidly, become large, or cause painful symptoms.
For malignant tumors, or large symptomatic benign tumors, the most common treatment is a splenectomy (surgical removal of the spleen). This procedure can be performed via traditional open surgery or a minimally invasive laparoscopic approach, which allows for faster recovery. Although the spleen is important, a person can live without it, but they may require specific vaccinations and prophylactic antibiotics due to an increased infection risk.
If the tumor is lymphoma or a metastatic growth, systemic therapies are often necessary alongside or instead of surgery. These treatments include chemotherapy, which uses drugs to kill cancer cells, and radiation therapy, which targets the tumor area with high-energy beams. Targeted therapy and immunotherapy drugs may also be used, depending on the cancer type and specific genetic markers.