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Splenosis mimicking an extramural duodenal mass: A case report.

Deng Y, Jin Y, Li F, Zhou Y - Oncol Lett (2014)

Bottom Line: Splenosis is frequently observed in the abdomen and pelvic cavity and may mimic malignancy on imaging, often leading to unnecessary surgical intervention.The aim of this report is to raise the awareness of this entity in patients post-splenectomy, to avoid unnecessary surgery, particularly with an increased prevalence of patients with previous splenic trauma due to road traffic accidents.Therefore, the possibility of abdominal splenosis must be included in the differential diagnosis of patients with abdominal mass as the main clinical manifestation, where there is a history of splenic trauma or splenectomy and no other systemic symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

ABSTRACT
Splenosis is a common disease, patients with splenosis are generally asymptomatic and therapy is not indicated. Splenosis is frequently observed in the abdomen and pelvic cavity and may mimic malignancy on imaging, often leading to unnecessary surgical intervention. The current study presents the case of a 55-year-old female patient, with a rare case of duodenal splenosis, who underwent unnecessary laparotomy due to a misdiagnosis of a malignant duodenal stromal tumor. Although splenosis was confirmed by intraoperative tissue biopsy, this mass was resected due to the lack of information with regard to this condition, an increased suspicion of progressive growth of the mass and chronic duodenal compression. The aim of this report is to raise the awareness of this entity in patients post-splenectomy, to avoid unnecessary surgery, particularly with an increased prevalence of patients with previous splenic trauma due to road traffic accidents. Therefore, the possibility of abdominal splenosis must be included in the differential diagnosis of patients with abdominal mass as the main clinical manifestation, where there is a history of splenic trauma or splenectomy and no other systemic symptoms. In the future noninvasive nuclear scintigraphy may serve as a suitable diagnostic approach for splenosis, thereby avoiding unnecessary laparotomies.

No MeSH data available.


Related in: MedlinePlus

Intraoperative image showed a dark red multi-nodular soft tissue mass of 6.5×4.8×2.6 cm in size among the duodenal bulb, hilar and the gastric antrum, suggesting ectopic splenic tissue.
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f2-ol-08-06-2811: Intraoperative image showed a dark red multi-nodular soft tissue mass of 6.5×4.8×2.6 cm in size among the duodenal bulb, hilar and the gastric antrum, suggesting ectopic splenic tissue.

Mentions: Following preoperative preparation and counselling with the patient and relatives, exploratory laparotomy was conducted. During surgery, a multi-nodular soft tissue mass with a dark red appearance, of 6.5×4.8×2.6 cm in size was observed around the duodenal bulb, hilar and the gastric antrum, with a blood supply from the duodenal wall (Fig. 2). The mass was predicted to be spleen tissue, confirmed by intraoperative tissue biopsy, however, the mass was resected to avoid any future problems that may arise. Following this, the patient was diagnosed with post-splenectomy duodenal splenosis, and was discharged on postoperative day 8 without any complications. During hospitalization, the platelet count increased from a preoperative level of 165×109/l (reference range, 100×109/l–300×109/l) to 314×109/l on the day of discharge. During the six month follow-up, the patient was asymptomatic and monthly ultrasonography revealed no abdominal abnormalities, however, the platelet count continued to rise to a maximum of 425×109/l in the first month following surgery, and thereafter, a progressive decline was observed and subsequently, platelet levels remained within the normal range.


Splenosis mimicking an extramural duodenal mass: A case report.

Deng Y, Jin Y, Li F, Zhou Y - Oncol Lett (2014)

Intraoperative image showed a dark red multi-nodular soft tissue mass of 6.5×4.8×2.6 cm in size among the duodenal bulb, hilar and the gastric antrum, suggesting ectopic splenic tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214512&req=5

f2-ol-08-06-2811: Intraoperative image showed a dark red multi-nodular soft tissue mass of 6.5×4.8×2.6 cm in size among the duodenal bulb, hilar and the gastric antrum, suggesting ectopic splenic tissue.
Mentions: Following preoperative preparation and counselling with the patient and relatives, exploratory laparotomy was conducted. During surgery, a multi-nodular soft tissue mass with a dark red appearance, of 6.5×4.8×2.6 cm in size was observed around the duodenal bulb, hilar and the gastric antrum, with a blood supply from the duodenal wall (Fig. 2). The mass was predicted to be spleen tissue, confirmed by intraoperative tissue biopsy, however, the mass was resected to avoid any future problems that may arise. Following this, the patient was diagnosed with post-splenectomy duodenal splenosis, and was discharged on postoperative day 8 without any complications. During hospitalization, the platelet count increased from a preoperative level of 165×109/l (reference range, 100×109/l–300×109/l) to 314×109/l on the day of discharge. During the six month follow-up, the patient was asymptomatic and monthly ultrasonography revealed no abdominal abnormalities, however, the platelet count continued to rise to a maximum of 425×109/l in the first month following surgery, and thereafter, a progressive decline was observed and subsequently, platelet levels remained within the normal range.

Bottom Line: Splenosis is frequently observed in the abdomen and pelvic cavity and may mimic malignancy on imaging, often leading to unnecessary surgical intervention.The aim of this report is to raise the awareness of this entity in patients post-splenectomy, to avoid unnecessary surgery, particularly with an increased prevalence of patients with previous splenic trauma due to road traffic accidents.Therefore, the possibility of abdominal splenosis must be included in the differential diagnosis of patients with abdominal mass as the main clinical manifestation, where there is a history of splenic trauma or splenectomy and no other systemic symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

ABSTRACT
Splenosis is a common disease, patients with splenosis are generally asymptomatic and therapy is not indicated. Splenosis is frequently observed in the abdomen and pelvic cavity and may mimic malignancy on imaging, often leading to unnecessary surgical intervention. The current study presents the case of a 55-year-old female patient, with a rare case of duodenal splenosis, who underwent unnecessary laparotomy due to a misdiagnosis of a malignant duodenal stromal tumor. Although splenosis was confirmed by intraoperative tissue biopsy, this mass was resected due to the lack of information with regard to this condition, an increased suspicion of progressive growth of the mass and chronic duodenal compression. The aim of this report is to raise the awareness of this entity in patients post-splenectomy, to avoid unnecessary surgery, particularly with an increased prevalence of patients with previous splenic trauma due to road traffic accidents. Therefore, the possibility of abdominal splenosis must be included in the differential diagnosis of patients with abdominal mass as the main clinical manifestation, where there is a history of splenic trauma or splenectomy and no other systemic symptoms. In the future noninvasive nuclear scintigraphy may serve as a suitable diagnostic approach for splenosis, thereby avoiding unnecessary laparotomies.

No MeSH data available.


Related in: MedlinePlus