eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2022-05-23 10 5 146 152 10.12691/ajmcr-10-5-7 AJMCR20221057 article Massimo Arcerito massimo.arcerito@gmail.com 1 Boris V Shlopov 2 Rafael Canseco 3 Thomas H Takei 4 Riverside Medical Clinic Inc., Department of General and Vascular Surgery, Associate Clinical Professor, University of California Riverside, School of Medicine, 21634 Retreat Pkwy, Temescal Valley, CA 92883 Director of Pathology, Department of Pathology, Corona Regional Medical Center, 800 S Main St, Corona CA, 92882 Department of Surgery, Corona Regional Medical Center, 800 S Main St, Corona CA, 92882 Riverside Medical Clinic, Department of Surgery, 7117 Brockton Ave, Riverside CA 92506 Splenic masses represent a clinical challenge when encountered by health care providers. These lesions must be excised completely and assessed histologically to differentiate benign and malignant diseases. Biopsy mass bleeding and false negative results are common. We report a 59 year old woman with no previous cancer history, with an incidental splenic mass found by abdominal ultrasound for left abdominal pain. Computer tomography scan and magnetic resonance imaging identified a solid nodular splenic lesion lacking definitive criteria for benign or malignant disease. Furthermore, liver/spleen scan ruled out hemangioma. After discussing the patient at tumor board, a robotic splenectomy was performed. The patient was discharged home 20 hours postoperatively. Sclerosing Angiomatoid Nodular Transformation (SANT) was confirmed by histology and immunohistochemistry. Imaging modalities are not helpful to clinch the diagnosis, leaving minimally invasive splenectomy and pathology to treat and assess this very rare splenic disease. http://pubs.sciepub.com/ajmcr/10/5/7/ajmcr-10-5-7.pdf Splenic mass Robotic splenectomy Immunohistochemistry Triple Vessels Disease Sclerosing Angiomatoid Nodular Transformation