Subcutaneous Splenosis of the Abdominal Wall: Report of a Case and Review of the Literature

Abstract

Splenosis is a common benign condition that occurs after splenic rupture via trauma or surgery. The mechanism behind splenic cell autotransplantation begins with the splenic rupture, either from trauma or surgical removal. Splenosis is usually found incidentally and, unless symptomatic, surgical therapy is not indicated. Subcutaneous splenosis is an extremely rare form of splenosis, mostly observed in abdominal surgical scars. We report a case of subcutaneous splenosis, as well as a comprehensive review of the literature. In our case, a 43-year-old woman who had splenectomy after traumatic splenic rupture at the age of 7 years old presented for plastic reconstruction of her postoperative scar. Upon surgery, two asymptomatic subcutaneous nodules were incidentally discovered. The presence of splenic tissue was confirmed by the histological study. The nodules were not excised, as the patient was not symptomatic.

Symptomatic isolated thoracic splenosis 11 years after abdominal trauma: Case report

“…A second mechanism is the hematogenous spread of splenic pulp, as suggested by case reports of intrahepatic, as well as intracranial splenosis [9,10,11]. In fact, all cases of reported thoracic splenosis had diaphragmatic rupture as well as splenic rupture [9,12]. In our case, spleen nodules were localized in the apex of the left lung with no evidence of them near the diaphragm.…”

“…The most common location of thoracic splenosis occurs in the pleural cavity, and most commonly involves a diaphragmatic tear, or rarely a diaphragmatic hiatus, and small pieces of splenic tissue are displaced into the left hemithorax through the diaphragmatic opening. A second mechanism is the hematogenous spread of splenic pulp, as suggested by case reports of intrahepatic, as well as intracranial splenosis [9,10,11]. In fact, all cases of reported thoracic splenosis had diaphragmatic rupture as well as splenic rupture [9,12].…”

Combined Intrathoracic and Subcutaneous Splenosis Discovered 51 Years after Abdominal Trauma

“…Subcutaneous splenosis is exceedingly rare with less than 20 reported cases, 16 of which were recently reviewed by Papakonstantinou et al They found that the majority of cases occur after gunshot wounds or, as with our patient, occur at the site of abdominal surgical scars [ 6 ].…”

“…Pelvic or abdominal splenosis occurs in up to 65% of splenic rupture cases [ 3 ] while thoracic implants are significantly less common making up only 18% of splenosis cases [ 1 , 4 , 5 ]. Subcutaneous splenosis is rare with less than 20 reported cases [ 6 ].…”

Splenosis: A Rare Etiology for Bowel Obstruction—A Case Report and Review of the Literature

“…Splenic fragments after trauma or surgery have the ability to heterotopically autotransplant onto vascularized intra- or extraperitoneal surfaces [ 1 , 2 ]. Most common locations of splenic deposits are in the vicinity of the left upper quadrant, typically involving the serosal surfaces of small and large bowel, the greater omentum, and diaphragm, but sometimes they can grow in the nearby mesentery or be found in very unusual locations [ 3 – 5 ]. Most cases are asymptomatic and are incidentally diagnosed during imaging studies or surgical explorations for other conditions [ 1 , 6 ].…”