Primary splenic angiosarcoma (PSA) is an exceedingly rare and aggressive vascular malignancy originating from endothelial cells of the splenic sinusoids with rapid progression and high metastatic potential underscoring the critical need for timely diagnosis. Its nonspecific early symptoms, such as fatigue, anemia, and abdominal pain, often lead to misdiagnosis or delayed recognition, while its imaging features can mimic benign conditions like hemangioma
