Spleen Cancer: Causes, Types, Symptoms, Diagnosis & Treatment

Spleen cancer is a rare form of malignancy that affects the spleen — a vital organ involved in filtering blood, storing white blood cells, and helping the immune system fight infection. Most commonly, cancers found in the spleen are not primary (originating in the spleen) but secondary, meaning they have spread (metastasized) from other parts of the body or involve the spleen due to blood-borne cancers like lymphomas or leukemias. Although spleen cancer is uncommon, it can be serious if not diagnosed and treated early. Understanding the nature of spleen-related malignancies, including their causes, symptoms, and treatment approaches, is essential for timely management.

Types of Spleen Cancer

Spleen cancer is generally classified into primary and secondary cancers:

• Primary Spleen Cancer
• Extremely rare.
• Can include:
• Primary Splenic Lymphoma
• Angiosarcoma of the Spleen
• Hemangiosarcoma
• Primary Splenic Cysts or Tumors (benign or malignant)
• Secondary Spleen Involvement
• More common than primary spleen cancer.
• Usually a result of:
• Lymphoma (Hodgkin’s or Non-Hodgkin’s)
• Leukemia (chronic or acute)
• Metastatic cancer from other organs such as breast, lung, or colon

Causes and Risk Factors

Due to the rarity of primary spleen cancers, the exact causes remain uncertain. However, some contributing factors and risks include:

• Immunodeficiency Conditions
• Patients with compromised immune systems (e.g., HIV/AIDS)
• Previous or Ongoing Hematologic Malignancies
• Such as lymphoma or leukemia
• Radiation Exposure
• Long-term exposure to radiation therapy may increase risk
• Genetic Predispositions
• Certain genetic mutations may increase susceptibility
• Chronic Infections
• Such as Epstein-Barr Virus (EBV) or other viral triggers

Symptoms of Spleen Cancer

Symptoms can be vague or absent in early stages, making diagnosis difficult without imaging or blood tests. Common signs and symptoms include:

• Persistent pain or discomfort in the upper left abdomen
• Feeling of fullness without eating (due to spleen enlargement)
• Fatigue and general weakness
• Unexplained weight loss
• Recurrent infections
• Fever or night sweats
• Easy bruising or bleeding
• Enlarged spleen (splenomegaly) detected on physical exam

Diagnostic Tests for Spleen Cancer

Diagnosis involves a combination of clinical evaluation, imaging studies, and laboratory tests:

• Physical Examination
• May reveal a palpable spleen due to enlargement
• Blood Tests
• CBC (Complete Blood Count) to evaluate white cells, red cells, and platelets
• Peripheral smear to identify abnormal cells
• Tumor markers depending on suspected type
• Imaging Tests
• Ultrasound Abdomen – to assess spleen size and texture
• CT Scan or MRI Abdomen – detailed cross-sectional images
• PET-CT Scan – for identifying metabolically active tumors and disease spread
• Bone Marrow Biopsy
• Often done in hematologic malignancies to assess marrow involvement
• Splenic Biopsy or Splenectomy (if necessary)
• Rare due to risk of bleeding, but may be required for definitive diagnosis

Treatment Options for Spleen Cancer

Treatment depends on whether the cancer is primary or secondary, localized or systemic. Options include:

1. Chemotherapy

• Primary treatment for lymphoma or leukemia involving the spleen.
• Drugs like CHOP or ABVD protocols for lymphoma.

2. Radiation Therapy

• Used selectively, especially in localized splenic lymphoma.
• Helps shrink the spleen or treat residual disease.

3. Targeted Therapy

• Drugs like rituximab for B-cell lymphomas or other targeted agents for specific genetic mutations.

4. Immunotherapy

• Boosts the immune system’s response to cancer (e.g., checkpoint inhibitors).

5. Splenectomy (Surgical Removal of the Spleen)

• Considered when:
• There is splenic rupture
• The spleen is excessively enlarged
• Localized splenic tumors or cysts exist
• Improves symptoms like pain or cytopenia (low blood counts)

6. Bone Marrow Transplantation

• Considered in recurrent or resistant blood cancers involving the spleen.

Conclusion

Although spleen cancer is rare, especially in its primary form, the spleen can often be involved in various blood cancers like lymphoma and leukemia. Early detection is key, especially when vague symptoms like fatigue, pain in the left upper abdomen, or abnormal blood counts appear. PET-CT, CT scan, and blood investigations form the backbone of diagnosis. Treatment strategies vary from chemotherapy and radiation to surgery in selected cases. Fortunately, with proper treatment, even secondary spleen involvement can be managed effectively, improving prognosis and quality of life. Regular follow-ups and imaging are essential to monitor disease progression and treatment response.