A Multinodular Mass of Abdominal Splenosis: Case Report of Uncommon Images of a Rare Disease

Abstract

Splenosis is a rare disease which typically forms single or multiple round masses. A 45-year-old male was referred for investigation of an abdominal mass. He had a history of splenic injury from a traffic accident at age 19. Contrast-enhanced computed tomography showed a well-enhanced, multi-nodular mass lesion, 3.5 cm in size, located below the stomach. An endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) for the mass was inconclusive. A surgery was performed, and pathology of the resected mass confirmed splenosis. Clinicians must bear in mind the possibility of occurrence of splenosis after splenic trauma and its image variations.

Gastric Splenosis Mimicking Gastrointestinal Stromal Tumor

“…The term splenosis represents the auto-transplantation of splenic tissue [ 1 ]. It was initially described in 1937 [ 2 ].…”

“…Splenosis is the translocation of splenic tissue, mostly caused by a traumatic injury to the spleen or iatrogenically after surgery [ 1 ]. It is usually seen in the abdominal and pelvic cavity, with gastric splenosis being a rare entity [ 2 ].…”

Splenosis mimicking lymphadenopathy

“…Most patients with splenosis are asymptomatic. It is usually found accidentally, during physical or imaging examination, autopsy or abdominal surgery for another reason [ 7 , 9 , 10 ]. That was the case with our patient who had the splenosis discovered during diagnosis for nephrolithiasis.…”

“…The differential diagnosis is important, because splenosis may mimic serious diseases such as metastatic cancer, lymphoma, primary liver or renal cancer. Accessory spleens, endometriosis, hemangiomas, multiple adenomas, granulomatous diseases, reactive adenopathy or peritoneal mesothelioma should also be taken into account in the differentiation [ 3 , 4 , 9 ].…”

Splenosis: fetters of the unknown or step through existing precautions (part I)

“…Помимо посттравматического генеза спленоз может иметь ятрогенный характер в случае целенаправленной аутотрансплантации ткани селезенки при необходимости удаления данного анатомического образования, проводящейся с целью профилактики постспленэктомического синдрома. Как правило, регенераторные очаги селезеночной ткани локализуются на париетальной и висцеральной брюшине, в ложе удаленной селезенки, но могут обнаруживаться во всем теле (даже в головном мозге), в различном количестве и разнообразных размеров [1][2][3][4][5].…”