Spleen Cancer: Types, Symptoms, Diagnosis & Treatment
Spleen Cancer: Types, Symptoms, Diagnosis & Treatment (Updated 2025)
“Spleen cancer” is a common phrase people search online, but medically it can mean different things. In practice, cancer involving the spleen is usually either:
- Primary splenic malignancy (cancer that starts in the spleen—rare), or
- Secondary / metastatic disease (cancer that spreads to the spleen from elsewhere—more common than primary, but still not the most frequent metastatic site).
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1) What the spleen does
The spleen sits in the upper-left abdomen and is involved in immune function and blood filtration. It helps remove old or damaged blood cells and supports immune responses—one reason splenic conditions can affect blood counts (anemia, low platelets, or abnormal white cells).
2) Primary spleen cancer (rare)
True primary cancers of the spleen are uncommon. The most frequent primary malignant conditions are typically from the lymphatic/blood system.
Primary splenic lymphoma (PSL)
Because the spleen contains abundant lymphoid tissue, lymphoma is the most common cancer type that may originate in the spleen. Examples of splenic lymphomas/leukemias that often involve the spleen include:
- Splenic marginal zone lymphoma (SMZL) (often indolent/slow-growing)
- Hairy cell leukemia (frequent spleen enlargement; modern targeted options exist for many cases)
- Other B‑cell non‑Hodgkin lymphomas that may present with splenic involvement
Splenic angiosarcoma
Angiosarcoma of the spleen is extremely rare and tends to be aggressive. It arises from cells lining blood vessels. Because it is uncommon and can present late, care is usually managed by a multidisciplinary oncology team (surgical oncology, medical oncology, pathology, radiology).
Other rare primary tumors
Other sarcomas or uncommon malignancies can occur, but they are far less frequent than lymphoma-related disease.
3) Secondary (metastatic) involvement of the spleen
The spleen can also be affected when cancer spreads from another organ (metastasis). This is more likely when there is widespread disease, but patterns vary by cancer type and biology.
Primary cancers that can involve the spleen include (not exhaustive):
- Melanoma
- Lung cancer
- Breast cancer
- Ovarian cancer
- Colorectal cancer
- Stomach cancer
- Pancreatic cancer
- Leukemias and systemic lymphomas (often cause spleen enlargement as part of body-wide disease)
4) Symptoms and warning signs
Symptoms can be subtle and may come from an enlarged spleen (splenomegaly), low blood counts, or systemic inflammation. Seek medical evaluation—especially if symptoms persist or worsen.
- Pain, pressure, or fullness in the upper-left abdomen (may radiate to the left shoulder)
- Early satiety (feeling full quickly), nausea, reduced appetite
- Unexplained weight loss
- Fever, night sweats (classically seen with some lymphomas)
- Fatigue (may reflect anemia or systemic illness)
- Easy bruising/bleeding (possible low platelets)
- Frequent infections (possible immune compromise)
5) How spleen cancer is diagnosed
Diagnosis typically includes a mix of clinical evaluation, lab testing, and imaging. The goal is to determine whether the spleen is enlarged, whether there is a focal lesion, and whether disease is localized or systemic.
Clinical exam + history
- Symptom review (pain, early satiety, fevers, weight loss)
- Physical exam (enlarged spleen may be palpable in some cases)
Blood tests
- CBC (complete blood count): anemia, abnormal white cells, low platelets
- Peripheral smear (in some hematologic conditions)
- LDH (sometimes elevated in aggressive lymphomas, not specific)
- Additional tests based on suspicion (viral testing, inflammatory markers, etc.)
Imaging
- Ultrasound: quick assessment of size/lesions
- CT abdomen/pelvis: lesion characterization, nodes, surrounding structures
- MRI: helpful for soft-tissue characterization in select cases
- PET/CT: commonly used for staging and response in many lymphomas
Biopsy (when needed)
Definitive diagnosis may require tissue. Depending on the case, clinicians may biopsy a safer site (like an accessible lymph node) rather than the spleen due to bleeding risk. Sometimes splenectomy is done for diagnosis and treatment.
6) Treatment options
Treatment depends on the underlying diagnosis (lymphoma vs metastasis vs another tumor), stage, symptoms, and overall health.
Common approaches
- Active surveillance: for select indolent conditions when safe and asymptomatic
- Splenectomy: may be diagnostic and/or therapeutic (symptom relief, cytopenias, localized tumors)
- Chemotherapy: a mainstay for many lymphomas and metastatic cancers
- Immunotherapy: used in various cancers (e.g., checkpoint inhibitors in some settings)
- Targeted therapy: depends on tumor biology (molecular markers)
- Radiation therapy: selected cases for local control or symptom relief
- Supportive care: transfusions, infection prevention, pain control, nutrition support
If the spleen is removed: key safety steps
People without a spleen (asplenia) have higher risk of certain serious infections. Clinicians often recommend:
- Vaccinations (timing and types depend on your situation)
- Knowing when to seek urgent care for fever
- Sometimes preventive antibiotics (case-by-case)
Always follow your surgeon/oncologist’s guidance.
7) Questions to ask your doctor
- Is my spleen issue more likely lymphoma, metastasis, infection, or benign disease?
- What did imaging show (size, focal lesion, lymph nodes, PET uptake)?
- Do I need a biopsy? If yes, what is the safest biopsy site?
- What stage is the disease, and what does that mean for prognosis?
- What are the goals of treatment (cure, control, symptom relief)?
- What side effects should I expect from treatment?
- If splenectomy is recommended, what vaccines do I need and when?
8) FAQ
Is spleen cancer common?
Primary spleen cancer is rare. The spleen is more commonly involved by blood cancers (lymphoma/leukemia) or, less commonly, by metastasis from other cancers.
Can a person live without a spleen?
Yes. Many people live full lives after splenectomy, but infection prevention (vaccines, fever precautions) becomes especially important.
What’s the first test for spleen problems?
Often a clinician starts with a physical exam, a CBC blood test, and an ultrasound or CT scan depending on symptoms and urgency.
When to seek care now
- Severe or worsening left-upper abdominal pain
- Fainting, dizziness, shortness of breath, chest pain
- High fever (especially if you’ve had splenectomy)
- Unexplained bruising/bleeding or extreme fatigue
References (high-quality patient resources)
- National Cancer Institute (NCI)
- CDC Vaccines (general information)
- Leukemia & Lymphoma Society (LLS)
- Mayo Clinic (patient education)
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