Solid Spleen Masses

[JanR]

I have 5 solid masses on my spleen which were found incidentally during a cat scan for another reason.  I have no symptoms on any kind.  After an MRI - three radiologists and one gastroenterologist cannot decide what they consist of.  They all agree that they are solid masses and could be either neoplastic, granulomous, or infectious. They say they are not metastic since they are no where on any other surrounding organs.  I had breast cancer 6 years ago - it was a very tiny tumor that was removed with clear margins and I had radiology as a preventative action. Then followed with 5 years of tamoxifen.  I am told the next step is a PET scan which my insurance company will not cover inless it is confirmed that they are cancerous.  I am told that a needle biopsy will give them an answer but my fear of that is that if they are cancerous do I want to take the chance of spreading the cancer cells.  Since I have no symptoms and would never know I had these if I hadn't had the other tests - is it prudent to wait for 4 - 6 months and have another MRI to see if there is any change.  I sort of lean towards just having a splenectomy and get it over with although one should not have surgery unless necessary I believe.  I am confused, not over concerned, I just am not sure what to do. The doctor does not appear to be all that concerned.  I am going to see another gastroenterologist for another opinion but I truly doubt he's going to have any more answers.  Do you have any suggestions?

[JanR]

Thank you so much.  I am very glad that I found this forum and website.
J

[Bhupinder Kaur, MD]

Hello,

You have explained the condition very well.
Unfortunately to determine what these solid masses are,PET scan and biopsy are needed.Without these it is very difficult to comment on the constituency of masses.A wait for some time and then getting repeat MRI done to check whether these masses have grown in size or not will be a more reasonable approach.Pls don’s get splenectomy done just for the sake of finding the composition of these masses,without any predisposing symptoms.

Pls note that tumors of the spleen are rare with cysts, haemangiomas, benign and malignant lymphomas being the most frequent.Metastasis is very rare although spleen is one of the most vascular organs.So chances of your prior breast cancer metastasis are also low.

I feel that a second opinion from a gastroenterologist will be the best.

Hope it helps.Take care and pls do keep me posted on how you are doing or in case you have any additional queries.