The spleen, an organ in the upper left abdomen, functions as part of the immune system and filters blood. A tumor on the spleen is an abnormal growth of cells within this organ, which can range from harmless masses to aggressive cancers.
Types of Splenic Tumors
Splenic tumors are classified into two main categories: benign and malignant. Benign tumors are non-cancerous and do not spread to other parts of the body. The most common type of benign splenic tumor is a hemangioma, a mass formed by an abnormal collection of blood vessels. These are often small and discovered by chance during imaging for other reasons.
Other benign tumors include hamartomas and lymphangiomas. Hamartomas are rare growths composed of the spleen’s own tissue that has grown in a disorganized way. Lymphangiomas are also uncommon and are made of lymphatic vessels. These tumors are often cystic, meaning they are fluid-filled, and are usually found in children and young adults.
Malignant tumors of the spleen are cancerous and have the potential to spread, or metastasize. The most common malignancy involving the spleen is lymphoma, a cancer of the lymphatic system. In many cases, lymphoma starts elsewhere in the body and involves the spleen as it progresses.
The spleen can also be the site of metastatic tumors. This occurs when cancer cells from another organ travel through the bloodstream and establish a new tumor in the spleen. Cancers that most commonly spread to the spleen include melanoma, lung, breast, and ovary. These secondary cancers are more common than cancers that originate in the spleen itself.
Associated Symptoms and Causes
Many individuals with a splenic tumor, particularly small benign ones, will not experience any symptoms. When symptoms do occur, they are often related to an enlarged spleen, known as splenomegaly. This can cause a feeling of fullness or pain in the upper left abdomen.
The enlarged spleen can press on the stomach, leading to fullness after eating a small amount of food. Other symptoms may include unexplained weight loss, fatigue, fever, and night sweats. Weakness and easy bruising can also be signs that the spleen’s blood cell management is affected. These symptoms are not exclusive to splenic tumors and can be caused by many other conditions.
The precise cause for most splenic tumors is not known, but certain conditions are recognized as risk factors. Blood cancers, such as leukemia and lymphoma, are strongly associated with the development of tumors in the spleen. Chronic infections, notably hepatitis C, have also been linked to an increased risk.
Some research suggests a connection between spleen cancer and exposure to environmental hazards like thorium dioxide or vinyl chloride. Genetic syndromes, autoimmune diseases, and a family history of certain cancers can also be contributing factors.
Diagnostic Procedures
The diagnostic process often begins with a physical examination. A doctor may be able to feel an enlarged spleen by pressing on the abdomen, which prompts further investigation to identify any lesions within the organ.
Imaging tests are used for diagnosing a splenic tumor. An ultrasound is frequently the first test used because it is non-invasive and can visualize the spleen’s size and detect masses. For more detailed views, a computed tomography (CT) scan is often employed to get clear information about the tumor’s size and shape.
Magnetic resonance imaging (MRI) may also be used for its superior detail of soft tissues, helping to differentiate between tumor types. In addition, blood tests like a complete blood count (CBC) can reveal abnormalities in blood cells, which might suggest an underlying condition like leukemia or lymphoma.
For a definitive diagnosis, a biopsy to obtain a tissue sample may be considered. However, a splenic biopsy is not always performed due to the risk of significant bleeding from this highly vascular organ. If tests strongly suggest a malignant tumor, or if a benign tumor is large and causing symptoms, a decision may be made to proceed directly with surgical removal, which then allows for a definitive diagnosis.
Common Treatment Pathways
The treatment for a splenic tumor depends on its type, size, and whether it is causing symptoms. For small, asymptomatic benign tumors, a strategy of watchful waiting is often adopted. This involves regular monitoring with imaging tests to ensure the tumor is not growing or changing, and no immediate intervention is necessary if it remains stable.
The most common treatment for large, symptomatic, or malignant splenic tumors is a splenectomy, the surgical removal of the spleen. This can be performed using a minimally invasive laparoscopic technique or through traditional open surgery. After removal, individuals have an increased susceptibility to certain infections, so vaccinations are administered to protect against specific bacteria.
For malignant tumors, additional treatments are often required. Chemotherapy is a common treatment for systemic cancers like lymphoma or for cancers that have metastasized to the spleen. Radiation therapy is used less frequently but may be an option to shrink a tumor, relieve pain, or as part of a broader cancer treatment plan.