Laparoscopic approach is the treatment of choice for sclerosing angiomatoid nodular transformation of the spleen

Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a newly defined benign spleen lesion. SANT is a rare disease first described by Martel et al. [1] in 2004. Fewer than 100 cases have been reported [2]. SANT is often asymptomatic and found incidentally. Although there are some characteristic image features for diagnosis, final diagnosis can only be confirmed by immunohistochemistry [3]. A 57-year-old Taiwanese woman who suffered from high fever came to the emergency department asking for help. After a series fever survey, abdominal computed tomography (CT) revealed a 3.5 cm 3.1 cm splenic tumor. She denied any gastrointestinal tract discomfort such as abdominal pain, poor appetite, diarrhea, nausea or vomiting. Her laboratory data were normal except for mild anemia. She denied any recent body weight loss, tarry stool or alterations of bowel habits. A stool occult blood study was also negative. In the arterial phase of her CT scan, the tumor was peripherally enhanced with radiation. In the delayed phase, the tumor showed progressive enhancement. A hypoenhanced center was noticed in both the arterial and delayed phase (Figures 1A and 1B). There was no imaging evidence of lymphadenopathy. Because the risk of malignancy could not be totally excluded, laparoscopic splenectomy was performed. The pathology report described a demarcated tumor mass in which a fibrotic and sclerosing background with multiple angiomatoid nodules of variable size were observed (Figure 1C). These nodules contained slit-like small vessels and sinusoids, with abundant plasma cells and histiocytes (Figure 1D). The sinusoids in these nodules were highlighted