Abdominal Splenosis Mimicking a Colon Tumour

Abstract

Splenosis is a benign condition which results from the self-implantation of splenic tissue on intra or extraperitoneal surfaces, after splenic trauma or splenectomy. Patients are usually asymptomatic but may present with varied symptoms related to the implantation site. The diagnosis is a challenge because abdominal splenosis can mimic several diseases, including neoplasm. The gold standard examination for its diagnosis is scintigraphy with 99mTc-labelled heat-denatured erythrocyte. When splenosis is found in an asymptomatic patient, surgical removal is not indicated. A 57-year-old male patient presented with sporadic epigastric pain and a suspected mass in the recto-sigmoid transition. Abdominal ultrasound, CT and MRI identified this mass, its characteristics and location, but failed to distinguish its nature. However, given the patient’s past history of splenectomy and because the mass showed a similar sign to that of the splenic parenchyma, a hypothesis of abdominal splenosis was raised, which was confirmed by scintigraphy with 99mTc-labelled heat-denatured erythrocyte. In this case, the diagnosis was obtained before the patient was subjected to more invasive procedures, which are associated with high morbidity, and, as in most cases, no targeted intervention was necessary.

Abdominal peritoneal splenosis (clinical case)

“…Определенную сложность в диагностике может составить вариабельность локализации, множественность очагов и рассыпной тип сосудистого рисунка, что вызывает необходимость дифференцировать спленоз с более серьезной патологией, а именно злокачественными новообразованиями: с гастроинтестинальной стромальной опухолью, лимфопролиферативными заболеваниями, мезотелиомой, диссеминированным метастатическим поражением брюшины, туберкулезным лимфаденитом и гепатоцеллюлярным раком [22,23].…”

Intraabdominal splenosis due to traffic accident

“…Splenosis is a benign process by which tissue from the spleen disseminates through the body and grows in an ectopic location as a result of splenic trauma or splenectomy. 1 The presence of heterotopic viable splenic tissue may be observed in other organs or within cavities, including especially peritoneum and retroperitoneum, pelvis, or thorax. The diagnosis of intraabdominal splenosis can be problematic because it can mimic several diseases, including various neoplasms, and may raise the suspicion of cancer dissemination.…”