Primary splenic carcinosarcoma: case report of a rare finding and review of the literature

Primary carcinosarcomas of the spleen are extremely rare malignancies with a poor prognosis. Their pathogenesis is not fully understood and guidelines concerning their diagnosis, or their therapy do not exist. A 55-year-old woman was admitted to our department with chronic pain in the upper left abdomen and a CT-validated mass in the spleen. After a splenectomy without complication, an extensive histopathological examination was conducted revealing a primary carcinosarcoma of the spleen. Further imaging was carried out to exclude a different origin of the tumor. Interdisciplinary discussion agreed upon an adjuvant chemotherapy. Eight months after surgery no signs of recurrence are present, and the patient reports no recurring symptoms. Splenic carcinosarcomas are unusual and bear a high potency for metastasis and a limited overall survival. The primary therapy is surgical removal with no general agreement concerning adjuvant chemotherapy. Further discussions relating to different therapy options are needed to provide sufficient care for affected patients.