Sclerosing angiomatoid nodular transformation of the spleen in an 18-year-old man: a case report.

Sclerosing angiomatoid nodular transformation (SANT) is a rare benign vascular lesion of the spleen, particularly uncommon in adolescents. We report the case of an 18-year-old man with an incidentally detected splenic mass showing a characteristic spoke-wheel enhancement pattern. Although a benign lesion was suspected, malignancy could not be excluded, and laparoscopic splenectomy was performed. Histopathological examination confirmed SANT, and the postoperative course was uneventful. A review of previously reported cases in patients younger than 20 years revealed a median age of 8.5 years, with abdominal pain in 76.9% and nonspecific laboratory abnormalities in 45.5% of cases. Partial splenectomy was performed in 46.7% of patients; however, tumors located at the splenic hilum were consistently treated with total splenectomy. SANT in adolescents is rare and difficult to diagnose preoperatively. Tumor location, particularly when located at the splenic hilum, may be a key factor in determining surgical strategy.