Acute, complete splenic infarction in cancer patient is associated with a fatal outcome

Splenic infarction frequently occurs in patients with myeloproliferative diseases, endocarditis, and sickle cell anemia. Various sonographic patterns of splenic infarction do exist, but little is known about tumor associated splenic infarction in cancer patients. Between January 1992 and December 2002, 66 patients were diagnosed with splenic infarction by color Doppler sonography (CDS). Ten patients had an underlying solid cancer. Clinical and sonographic data of cancer patients were evaluated retrospectively with regard to age, sex, frequency of thrombotic episodes, splenic size, echomorphology and vascularity of splenic lesions, and follow-up examination. The median age was 53 years (range, 16-73 years). Nine of 10 patients had abdominal metastases, four had evidence of a hypercoagulable state, five had a small spleen (< 7 X 3 cm), and seven had acute complete infarction of the spleen without hilar and parenchymal vessels on CDS. Survival of six patients with acute complete infarction ranged from I to 30 days. In cancer patients with splenic infarction, an acute complete infarction is the most common pattern. It is caused predominantly by a hypercoagulable state and is associated with an extremely short survival.