Intrahepatic splenosis mimicking hepatic neoplasia

Teles, Gabriel Neves Saad; Monteiro, Paulo Eduardo Zerati; Raphe, Raphael

doi:10.1016/j.ijscr.2018.02.021

Cited by 9 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One hypothesis is that an invagination or an exophytic growth of splenic tissue directly seeded into the liver capsule. With this mechanism, the most frequent site of IHS is the area surrounded by the left lobe and the diaphragm because it can be easily seeded with splenic tissue during splenectomy (14,(16)(17)(18). The other is that hematogenous spread due to the entry of an erythrocyte progenitor cell into the portal venous system.…”

Section: Discussionmentioning

confidence: 99%

A rare intrahepatic splenosis mimicking hepatocellular carcinoma: A case report

Umeda,

Tomihara,

Maeda

et al. 2023

Mol Clin Oncol

View full text Add to dashboard Cite

Intrahepatic splenosis (IHS) is a rare disease that is considered to result from heterotopic autotransplantation or implantation of splenic tissue after splenic trauma or surgery. A 46-year-old man with a treatment history of a left lateral liver segmentectomy and splenectomy for a road traffic injury 30 years earlier presented to Sakai City Medical Center (Sakai, Japan) with acute abdominal pain in November 2019. Physical examination showed no significant signs, and serum data were normal. Computed tomography revealed a hypodense mass measuring 2.5x1.7 cm in segment 7 of the liver. Gadoxetic acid-enhanced magnetic resonance imaging showed early enhancement in the arterial phase and washout in the delayed phase. Therefore, laparoscopic surgery was performed with a preoperative diagnosis of hepatocellular carcinoma. Pathological examination of the tumor showed IHS. The postoperative course was uneventful, and the patient developed no new abnormal region in the liver during 2 years of follow-up. The present study presented a case of IHS assumed to be hepatocellular carcinoma. IHS should be considered as a differential diagnosis of a liver mass detected years after splenic trauma or surgery, even in cases with imaging patterns suggesting malignancy.

show abstract

Section: Discussionmentioning

confidence: 99%

A rare intrahepatic splenosis mimicking hepatocellular carcinoma: A case report

Umeda,

Tomihara,

Maeda

et al. 2023

Mol Clin Oncol

View full text Add to dashboard Cite

show abstract

“…This occurs in 67% of patients with splenic rupture and splenectomy. [ 11 ] An accessory spleen is clinically crucial in some locations. When an accessory spleen is situated in another site, it may mimic some tumors, such as pancreatic and adrenal tumors.…”

Section: Discussionmentioning

confidence: 99%

Rare case of upper gastrointestinal hemorrhage due to accessory spleen: A case report

et al. 2022

View full text Add to dashboard Cite

Rationale: Upper gastrointestinal hemorrhage (UGIH) is defined as hemorrhage originating from the gastrointestinal tract proximal to the ligament of Treitz. The causes of UGIH include esophagitis, gastritis, peptic ulcers, Mallory-Weiss syndrome, and cancer. However, a rare cause of UGIH, such as an accessory spleen, may lead to serious complications if left untreated and can sometimes be very difficult to diagnose preoperatively.Patient concerns: An 18-year-old man was admitted to the Department of Gastroenterology of our hospital due to "repeated black stool for 2 months with aggravation, accompanied by hematemesis for 9 days." He denied any history of hepatitis, trauma, or surgery.Diagnosis: Laboratory evaluation revealed severe anemia (hemoglobin, 6.4 g/dL). Computed tomography revealed a mass measuring 127 mm in its largest dimension, located in the upper left abdomen, with varicose veins in the gastric fundus. Moreover, distended blue-purple tortuous veins were observed by gastroscopy in the gastric fundus. We believed the mass was likely an abnormally proliferating accessory spleen; however, the causes of severe anemia and gastrointestinal hemorrhage were unknown.Interventions: After discussion in a multidisciplinary conference, the mass was completely resected laparoscopically, and the subserosal veins in the gastric fundus were sutured using absorbable threads.Outcomes: After the surgery, the patient recovered uneventfully without any complications. Clinicopathological examination showed that the mass was chronic congestive splenomegaly. Gastrointestinal hemorrhage secondary to an abnormally proliferating accessory spleen was confirmed as the diagnosis. Laboratory evaluation revealed hemoglobin at 12.1 g/dL 2 months after surgery. At the 12-month follow-up, the patient showed no recurrence of gastrointestinal hemorrhage.Lessons: UGIH caused by accessory spleen is extremely rare. This entity should be considered in differential diagnosis of gastrointestinal hemorrhage. Surgical intervention is necessary for timely diagnosis and treatment in case of gastrointestinal hemorrhage in critical clinical situations.

show abstract

“…One theory states that the splenic tissue implants on or around the hepatic capsule physically and then subsequently invaginates into the hepatic parenchyma. Another theory suggests that the splenic tissue embolizes via the portal system into the liver and subsequently grows [ 2 , 3 , 8 , 9 ]. The presence of this functional splenic tissue is often supported by the patient's lack of siderocytes, Howell-Jolly bodies, Heinz bodies, and pitted red blood cells on laboratory samples [ 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…bleeding, infection), patient inconvenience, and use of health system resources (including time of procedural physician and pathologist). The reference standard imaging modality is scintigraphy with Tc-99m labelled heat-denatured red blood cells (Tc-99m-DRBC) [5] , [10] , however increasingly splenosis is confidently diagnosed with multiphasic cross-sectional imaging, particularly MRI, with multiple published reports outlining imaging features of both general and hepatic splenosis [ [1] , [2] , [3] , [4] , [5] , [8] , [9] , [10] , [11] ,].…”

Section: Discussionmentioning

confidence: 99%

A case of hepatic splenosis in the setting of iron overload; multimodal and literature review

Richardson

Gardner

Eberhardt

et al. 2021

Radiology Case Reports

View full text Add to dashboard Cite

Hepatic splenosis, a rare entity, is the ectopic implantation of splenic tissue into the hepatic parenchyma, most often incidentally seen in patients with a history of splenic trauma and splenectomy. We present a unique case of hepatic splenosis in a patient with hemosiderosis and splenectomy following the incidental finding of hepatic masses on pretransplant imaging. Final diagnosis was made based on cross-sectional imaging characteristics matching that of the left upper quadrant splenules alone. We discuss common characteristics of hepatic splenosis on multiple modalities, the effect of iron deposition on the imaging characteristics of hepatic and splenic tissue and how that impacts the differential and diagnosis. This case highlights the unique imaging characteristics hepatic splenosis can have particularly in the setting of hemosiderosis. Hepatic splenosis imaging diagnosis has a significant advantage over tissue diagnosis in terms of decreased risk, time and cost.

show abstract

Intrahepatic splenosis mimicking hepatic neoplasia

Abstract: HighlightsHepatic splenosis is a rare clinical occurrence.Hepatic splenosis mimics neoplasia.Focal hepatic lesions must be differentially diagnosed in patients whose spleens have been removed.The diagnosis cannot be made until after surgical resection.

Cited by 9 publications

References 8 publications

A rare intrahepatic splenosis mimicking hepatocellular carcinoma: A case report

A rare intrahepatic splenosis mimicking hepatocellular carcinoma: A case report

Rare case of upper gastrointestinal hemorrhage due to accessory spleen: A case report

A case of hepatic splenosis in the setting of iron overload; multimodal and literature review

Contact Info

Product

Resources

About