We report a case of pathological splenic rupture as a manifestation of malignant metastatic spindle cell tumour. To the best of our knowledge, this is the first case report of an atraumatic-pathological rupture of the spleen secondary to metastatic malignant spindle cell tumour. A 63-year-old man with a previous history of right upper limb amputation for an axillary malignant spindle cell tumour was admitted with an acute abdomen. Computed tomography showed a ruptured spleen. The patient subsequently underwent splenectomy. Histopathology confirmed the presence of malignant metastatic spindle cell tumour. Pathological splenic rupture is a rare manifestation of metastatic malignant spindle cell tumour. Background oncological history and thorough examination of the musculoskeletal system may provide important clues to make a prompt diagnosis.
Humans ; Male ; Middle Aged ; Rupture, Spontaneous ; diagnostic imaging ; etiology ; Sarcoma ; complications ; diagnostic imaging ; pathology ; Spleen ; diagnostic imaging ; pathology ; Splenectomy ; Splenic Neoplasms ; complications ; diagnostic imaging ; pathology ; Splenic Rupture ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed

Russell bodies (RB) are rare manifestations within the lower gastrointestinal tract. To date, there are only three other reported cases of RB lesions of the colon; two were polyps, and the third was a case of a multifocal RB lesion of the gastrointestinal tract. This paper reports a case of a tubulovillous adenoma with RB of the sigmoid colon in a patient diagnosed incidentally as part of the UK National Health Service Bowel Cancer Screening Programme. A thorough hematological investigation is required to exclude hematological malignancies because of its association with plasma cell neoplasm. These lesions should undergo clonality analysis to exclude the monoclonal proliferation of plasma cells. Ideally, a bone marrow aspirate and investigations for amyloidosis should be performed to exclude underlying hematological malignancies.

Russell bodies (RB) are rare manifestations within the lower gastrointestinal tract. To date, there are only three other reported cases of RB lesions of the colon; two were polyps, and the third was a case of a multifocal RB lesion of the gastrointestinal tract. This paper reports a case of a tubulovillous adenoma with RB of the sigmoid colon in a patient diagnosed incidentally as part of the UK National Health Service Bowel Cancer Screening Programme. A thorough hematological investigation is required to exclude hematological malignancies because of its association with plasma cell neoplasm. These lesions should undergo clonality analysis to exclude the monoclonal proliferation of plasma cells. Ideally, a bone marrow aspirate and investigations for amyloidosis should be performed to exclude underlying hematological malignancies.