A 47-year-old post-menopausal woman with type 2 diabetes presented for evaluation of asymptomatic anemia for one year. On examination, she appeared pale. A hard, enlarged spleen was palpated. The hematological investigation disclosed only iron deficiency anemia. Barium enema and upper gastrointestinal series were negative. An abdominal computed tomographic (CT) scan revealed an enlarged, bulging spleen with several irregular low-density areas and a large focus of calcification in the hilus.
Sonography revealed a 9 x 8 x 10 cm, well-circumscribed, echogenic mass within the spleen with cystic components. Coarse calcification was detected near the splenic hilum. Immunocytochemistry indicated metastatic malignant melanoma. A detailed examination, including gynecological, ENT, ophthalmological, and endoscopic gastrointestinal examination, was negative. No suspicious lesion was found. A…
