# Case Report: Sclerosing angiomatoid nodular transformation of the spleen: surgery or conservative treatment?

## TL;DR

A rare spleen condition called SANT is reported, and the paper discusses whether surgery or conservative treatment is better for managing it.

## Contribution

This case report provides insights into the management of SANT by suggesting surgical resection as an effective treatment option.

## Key findings

- Surgical resection is an efficient treatment for SANT without clinical symptoms.
- SANT is associated with blood vessel hyperplasia and lacks conventional tumor markers.
- SANT often co-occurs with leukemia and may involve CTNNB1 exon 3 deletion.

## Abstract

Sclerosing angiomatoid nodular transformation (SANT)is a rare vascular sclerosing mass-like lesion, often discovered incidentally during routine imaging evaluation or during visits for the patient’s primary disease. SANT has complex pathological manifestations, unknown natural course of development and rarity, which makes it difficult for clinicians and pathologists to define its true nature. We report a 55-year-old male patient who came to see a doctor due to a physical examination accidentally found a spleen mass. He had hypertension and hyperlipidemia, and had no obvious clinical symptoms. After that, he underwent surgical resection of the spleen, and the patient had no special discomfort after treatment. Our results show that surgical resection is an efficient treatment for SANT patients without obvious clinical symptoms, but the patient ‘s comprehensive conditions should also be considered.

Case report on sclerosing angiomatoid nodular transformation (SANT) of the spleen explores surgery versus conservative treatment. It questions if it is a reactive or precancerous lesion. Pathology shows blood vessel hyperplasia. No conventional tumor markers are expressed. SANT often co-occurs with leukemia. HUMARA reveals polyclonal cases. Wnt/β-catenin involves CTNNB1 exon 3 deletion. Contrast-enhanced ultrasound displays early arterial enhancement.