Cecal splenosis mimicking gastrointestinal stroma tumor. Case report and review of the literature

Abstract

Introduction Abdominal splenosis is a rare condition where autotransplanted ectopic spleen tissue is found in the abdominal cavity after spleen injury or splenectomy. While abdominal splenosis is mostly described as asymptomatic, bowel splenosis can present with abdominal pain, obstipation or gastrointestinal (GI) bleeding. Scarce information on bowel splenosis exists and high index of suspicion is needed for diagnosis. We present the case of a patient with abdominal pain and a cecal mass mimicking gastrointestinal stroma tumor (GIST) found to have bowel splenosis after laparoscopic resection. Presentation of case A 45-year-old female was evaluated for a 6-month history of abdominal pain in right-lower quadrant. She had past medical history of blunt abdominal trauma and splenectomy 35 years before symptoms. An abdominal contrast-enhanced computed tomography (CT) reported a 4.2 × 4.6 × 4.6 cm solid mass located in the antimesenteric border of the cecum, with calcifications and arterial enhancement. Colonoscopy found no epithelial lesions. A diagnostic laparoscopy was done, and resection of the mass achieved. Transoperative histopathological diagnosis revealed ectopic spleen tissue. Discussion It is difficult to know whether abdominal pain in bowel splenosis is actually triggered by splenosis itself or by an unrelated cause, making diagnosis incidental. There are no particular imaging findings suggestive of splenosis, and surgical resection is often done under uncertain diagnosis. Conclusion Bowel splenosis could present as abdominal pain variable time after spleen injury or splenectomy. Clinical features and imaging characteristics are nonspecific and similar to those of GIST. Most cases of splenosis are diagnosed after surgery.

Esplenúnculo intrapancreático simulando neoplasia

“…Los esplenúnculos suelen constituir un "incidentaloma". Los estudios imagenológicos están limitados para hacer el diagnóstico, pues la tomografía computarizada, la resonancia nuclear magnética y la ultrasonografía presentan características imagenológicas similares con los tumores pancreáticos hipervascularizados, como las neoplasias neuroendocrinas o los carcinomas de células acinares 8,9 . Alrededor de las dos terceras partes de los pacientes con bazo accesorio intrapancréatico presentan una masa de 1 a 2 cm de diámetro, bien delimitada y localizada predominantemente en la cola del órgano 10 .…”