Where is My Spleen? – A Case of Splenosis Diagnosed Years Later after Splenectomy

Abstract

Hepatic splenosis was first described in 1939 and is a rare condition that results from splenic trauma or splenectomy.A 43-year-old man with a past medical history significant for a prior splenectomy was admitted to the hospital due to right upper quadrant pain for two days. Magnetic resonance imaging (MRI) of the abdomen suggested features of hepatic adenoma, however, a percutaneous biopsy showed the mass within the liver to be a discrete collection of splenic tissue, apparently the result of a traumatic splenic rupture years ago.Hepatic splenosis is a rare entity, and due to the asymptomatic nature of this condition, most cases are found incidentally after different imaging modalities are done. The management of this entity is based on conservative measures. We report this case to emphasize that in the appropriate clinical setting, hepatic splenosis should be considered in the differential diagnosis of a patient with a homogenous well-circumscribed liver mass.

Subcutaneous Splenosis Presenting 37 years post-traumatic splenectomy; A Case Report

“…The splenic tissue present in our case is functionally active, as evidenced by the absence of Howell-Jolly bodies, Heinz bodies and other erythrocytes abnormalities in the peripheral smears of many asplenic patients with splenosis [12] . Management of this rare entity is conservative and surgical treatment is only indicated when patient is symptomatic [15] .…”

Splenosis mimicking metastatic abdominal and pelvic tumours in a 12-year-old female patient

“…There have been reports of thoracic splenosis, both with and without diaphragm rupture [1,15]. The spread by blood vessels explains the cases of splenosis in the liver parenchyma [18][19][20][21], pancreas [4], mammary gland, and even the brain [11,12]. In the described case, the location of the lesions is typical and includes the greater omentum, intestinal wall and its mesentery, parietal peritoneum, and pelvis.…”

“…Unfortunately, this method is difficult to access in routine diagnostics. In doubtful cases, a biopsy of the lesion or laparoscopic sampling for microscopic examination is necessary [20][21][22]. In this patient, due to the ambiguous results of imaging tests suggesting neoplastic disease, the final diagnosis was made after laparoscopic surgery, and it was based on the histopathological examination of the lesions.…”

“…Appendicitis or hydronephrosis due to pressure on the appendix or ureters also can occur [17]. During routine physical examination a tumour in the abdomen can be palpatedit can be asymptomatic [14,19,20] or it can cause abdominal pain [18,21,22]. Location in the thorax may cause haemoptysis and pleural pain [2,13,15].…”

“…by omentectomy or resection of a part of the intestine with the lesion [2,13,15]. Surgical removal of the lesions should not be undertaken in patients with asymptomatic clinical course, who were diagnosed accidentally [19,21,22].…”