Hypersplenism caused by an accessory spleen mimicking an intra-abdominal neoplasm: Report of a case

Ruíz-Tóvar, Jaime; Ripalda, Emilio; Beni, Rafael; Nistal, Jose; Monroy, Carlos; Carda, Pedro

doi:10.1007/s00595-008-3919-z

Cited by 2 publications

(2 citation statements)

References 5 publications

(6 reference statements)

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“…A PubMed search of the literature using the keywords “accessory spleen” and “pelvis” resulted in the identification of only 9 cases of an accessory spleen in the pelvis [ 2 – 9 ], including our case (Table 1 ). These cases included 3 men and 6 women, ranging in age from 17 to 75 years (median, 43 years).…”

Section: Case Presentationmentioning

confidence: 99%

Dynamic computed tomography findings of an accessory spleen in the pelvis: a case report

et al. 2016

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We report the case of a 60-year-old man with an accessory spleen in the pelvis. He visited our outpatient clinic because of abdominal discomfort. Computed tomography (CT) showed an enhanced mass (40 mm in diameter) in the pelvis. Preoperative diagnosis was difficult even after magnetic resonance imaging and colonoscopy. The patient underwent surgery for suspicion of a gastrointestinal stromal tumor or malignant lymphoma of the rectum. Intraoperative findings showed a mass in the pelvis and a long cord-like tissue reaching the mass and arising from the great omentum; the mass was excised. Histopathologic examination indicated that the mass was splenic tissue, and feeding vessels were found in the cord-like tissue, which were determined to be derived from the left gastroepiploic artery and vein. Thus, we diagnosed it as an accessory spleen in the pelvis. An accessory spleen is not rare and can occur anywhere in the abdominal cavity. However, an accessory spleen in the pelvis is an infrequent finding, and only 9 other cases of an accessory spleen in the pelvis have been reported. Therefore, it is very difficult to make a correct diagnosis preoperatively. However, 7 of the 9 cases (77.8 %) of a pelvic accessory spleen had vascular pedicles from the great omentum or splenic hilum as feeding vessels; hence, determining the feeding blood vessels on dynamic CT may be useful for diagnosing an accessory spleen in the pelvis. Additionally, if the accessory spleen is symptomatic or has a vascular pedicle, surgeons should attempt to resect the accessory spleen in the pelvis using minimally invasive laparoscopy.

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Section: Case Presentationmentioning

confidence: 99%

Dynamic computed tomography findings of an accessory spleen in the pelvis: a case report

et al. 2016

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“…The radiological and pathological literature report that approximately 75% of splenules are located in the splenic hilum, 20% near or in the pancreatic tail, and 5% in other regions. Cases of splenules found in the pelvis, groin, gonads, kidneys, adrenal glands, gastrosplenic ligament, liver, gastric wall, intestinal wall, omentum, and mesentery, as well lungs have been reported [2,4,[8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors

et al. 2020

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Objectives Ferumoxytol is an ultra-small superparamagnetic iron oxide (USPIO) agent that is taken up by splenic tissue. This study describes our initial institutional experience of ferumoxytol-enhanced MRI (feMRI) for differentiating intrapancreatic splenules (IPS) from other pancreatic lesions. Methods In this retrospective study, patients with computed tomographic imaging that identified small enhancing lesions in the tail of the pancreas subsequently underwent feMRI for further characterization. The feMRI protocol included T2-weighted (T2w) imaging with and without fat suppression (FS), R2* mapping, diffusion-weighted imaging (DWI), and T1-weighted (T1w) imaging with FS, prior to contrast injection. Immediately after slow intravenous infusion with 3 mg/kg body weight ferumoxytol, T1w was repeated. Delayed imaging with all sequences were obtained 24–72 h after ferumoxytol administration. Results Seven patients underwent feMRI. In two patients, the pancreatic lesions were presumed as pancreatic neuroendocrine tumor (PNET) from feMRI and in the remaining 5 IPS. One of the two patients with PNET was symptomatic for NET. In another symptomatic patient with pathologically proven duodenal NET and suspected PNET, the pancreatic lesion was proven to be an IPS on feMRI. IPS demonstrated strong negative enhancement in feMRI on T2w and increased R2* values consistent with splenic tissue, while the presumed PNETs did not enhance. T2w FS was helpful on the pre-contrast images to identify IPS, while R2* did on post-contrast images. Neither DWI nor T1w contributed to differentiating PNETs from IPS. Conclusions This study demonstrates the potential utility of feMRI as a helpful adjunct diagnostic tool for differentiating IPS from other pancreatic lesions. Further studies in larger patient cohorts are needed.

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Hypersplenism caused by an accessory spleen mimicking an intra-abdominal neoplasm: Report of a case

Cited by 2 publications

References 5 publications

Dynamic computed tomography findings of an accessory spleen in the pelvis: a case report

Dynamic computed tomography findings of an accessory spleen in the pelvis: a case report

Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors

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