Incidental finding of intramural splenic heterotopy in the colon mimicking subepithelial neoplasm: a case report.

AIM: The aim of this case report is describe an unprecedented case with histological and immunohistochemical diagnosis of splenic heterotopy in the colon using material obtained by endoscopic ultrasound-guided biopsy. BACKGROUND: Splenic heterotopia is a benign condition characterized by the implantation of splenic tissue in areas distant from its usual anatomical site, such as the peritoneum, omentum, mesentery, liver, pancreas, and subcutaneous tissue and, more rarely, in locations such as the colon and brain. It is generally associated with a history of splenic trauma or splenectomy and typically does not cause specific symptoms. CASE PRESENTATION: A 35-year-old white male patient who was healthy, with no history of trauma or splenectomy, but had a family history of colorectal neoplasia underwent colonoscopy for screening. The examination revealed a large bulge in the proximal descending colon, covered by normal-appearing mucosa. Endoscopic ultrasound-guided puncture was performed with a 22 gauge fine needle biopsy, and the histopathological and immunohistochemical analysis results were consistent with a heterotopic spleen. CONCLUSIONS: This is the first report of a primary intramural colic splenosis case with histological and immunohistochemical diagnosis of splenic heterotopia in the colon, using material obtained by endoscopic ultrasound and ultrasound-guided biopsy.

A rare case of concurrent intrahepatic splenosis and pancreatic adenocarcinoma following splenectomy.

We present an extremely rare case of intrahepatic splenosis (IHS). On admission and examination, the patient was diagnosed with hepatocellular carcinoma and postoperative injury or inflammatory lesions of the pancreas, based on image analysis. Postoperative histopathology showed that the lesions of the liver and diaphragm were of splenic origin, and the pancreatic lesion was identified as a moderately differentiated adenocarcinoma. The lesson of this case is that if there is a history of splenic rupture or splenectomy, even in the presence of hepatitis or cirrhosis, doctors should be alert to the possibility of IHS. Furthermore, splenectomy may affect the blood supply to the tail of the pancreas, so patients with a pancreatic tail mass following splenectomy need follow-up and biopsy, if necessary.

Pelvic splenosis: A systematic review of the literature.

Background: Splenosis is the presence of ectopic autotransplantation of splenic tissue in various compartments of the human body, occurring after rupture of the splenic parenchyma. Methods: A systematic PubMed and Scopus search was conducted. Results: The mean age of the patients was 51.7 years. The majority of patients were of female gender. An emergency presentation was noted in 30 out of 85 patients, having abdominal pain as main symptom. The principal reason for splenectomy were traffic accidents. The time span between splenectomy and the initial symptoms ranged between 1 and 57 years. The most frequent symptom at presentation of pelvic splenosis was abdominal pain. Almost a quarter of the included patients were without any symptom. Presence of extrapelvic splenosis was de-scripted in almost half of the included patients. With regards to the type of treatment provided, exploratory laparotomy, laparoscopic surgical exploration / laparoscopy, robotic removal of splenium and watchful waiting, were performed in 35 (41.2%), 32 (37.6%), 3 (3.5%) and 15 (16.3%) patients, respectively. No fatality was reported. Conclusion: Pelvic splenosis is a rare clinical condition. It may mimic several clinical conditions and mislead diagnosis. The clinical history of splenectomy for trauma or different other reasons may es-tablish diagnosis and exclude other morbidities. Excision and complete removal of pelvic splenosis nodules is not always necessary and it depends on the clinical symptomatology. Careful imaging and precise assessment with the assistance of nuclear medicine may lead to correct diagnosis and avoid unnecessary surgical interventions.

Splenosis as an incidental finding in a patient with multifactorial anemia.

A clinical case of a patient from our institution under study for anemia of multifactorial origin in whom splenosis was detected as an incidental finding.

Post-traumatic multifocal abdominal splenosis. The role of the clinical history. Case report and review of literature.

BACKGROUND: Splenosis is a benign clinical condition caused by the heterotopic autotransplantation of spleen's tissue tipically occurring after spleen rupture. Splenosis may be asymptomatic and found accidentally. When signs and symptoms occur they are due to mass effect or bleeding of the splenic nodules. CASE REPORT: 74-years-old male presenting with intestinal sub-occlusion and past medical history of post-traumatic splenectomy at 18-years-old. Based on TC findings of multiple hyperenhanced solid lesions located in greater omentum, mesentery and parietal peritoneum of right pelvic walls, the presumptive diagnosis was peritoneal carcinomatosis of unknown primary site. Stenosis of a ileum loop in the right pelvis, with dilatation and faecal stasis of the upstream loops proximal, required surgical procedure. At the opening of the peritoneal cavity the multifocal lesions varied in size, were reddish blu color, sessile, lobulate and with strong adhesions to the visceral peritoneum. Omentectomy and the blunt exicision of 3 extraparietal solid nodules, which had tenacious adhesions with stenotic ileum loop serosa for the lenght of 8 cm, were performed. Histopathological examination of surgical specimens showed splenic tissue with red pulp. CONCLUSION: CT scan usually do not allow to make a certain diagnosis of splenosis, so the clinical history of splenic trauma or splenectomy, positive in all cases reported in literature, represent the key in the diagnostic pathway of splenosis. Management should be conservative as much as possible nonetheless in abdominal splenosis the surgical approach should be chosen for the symptomatic patients who present abdominal pain, occlusion or bleeding. KEY WORDS: Abdominal, Splenosis, Spleen, Surgery.

Pelvic mass causing hematospermia: splenosis.

BACKGROUND: Most patients with splenosis have no clinical symptoms and do not need intervention. Hematospermia and testicular pain occurred in this patient, which was considered to be related to the huge pelvic implantation of the spleen, which was relatively rare in clinical practice, so we hereby report this case. CASE PRESENTATION: A 28-year-old male patient with a history of splenectomy was admitted to the Urology Department of the Second Affiliated Hospital of Anhui Medical University with the chief complaint of "Hematospermia for 1 month and testicular pain for 2 days". Preoperative imaging examination indicated pelvic mass. Combined with the patient's history of splenectomy for splenic rupture in childhood, the possibility of pelvic spleen implantation was considered. Laparoscopic pelvic exploration was performed. During the operation, multiple grayish-brown nodular tissues were observed in the space between the posterior bladder and rectum, and a lobulated grayish-brown mass with a diameter of about 9 cm was observed in the posterior upper part of the prostate gland and seminal vesicle at the pelvic floor. Two nodular tissues were removed intraoperatively and sent for quick frozen pathology, which was reported as spleen tissue. Further resection of the huge mass was performed, and the postoperative pathological results were consistent with the diagnosis of splenosis. CONCLUSION: We report a rare case of splenosis presenting with hemospermia and testicular pain.

Thoracic splenosis mimicking pleural tumor after firearm injury: A case report with long-term follow-up.

Splenosis describe a clinical entity of autotransplantation after removal of the spleen secon-dary to a traumatic rupture or surgery. A 39-year-old female was referred to thoracic surgery department with complaints of severe chest pain. She had left thoracic and abdominal gun-shot injury that occurred 19 years earlier. Thorax computed tomograhy and thorax magnetic resonance imaging revealed pleural lesions. A video thoracoscopic biopsy disclosed splenosis in the patient. Splenic implants did not change in 6 years. The patient has mild thoracic pain. Thoracic splenosis can occur in patients who underwent abdominothoracic gunshot injury. The implants did not seem to change in long-term follow-up. Thoracic splenosis may occur, persist for years and it mimics pleural tumor after abdominal gun-shot injury and does not seem to necessitate any surgical intervention including diaphragmatic repair.

[Post-traumatic thoracic splenosis]. / Klinicheskii sluchai posttravmaticheskogo grudnogo splenoza.

Splenosis is a rare disease and defined as spleen tissue autotransplantation following spleen rupture and subsequent splenectomy in most cases. The authors report ectopic splenic tissue in pleural cavity diagnosed in 31 years after blunt thoracoabdominal trauma.

Thoracic Splenosis, a Challenging Diagnosis / Esplenosis torácica, un diagnóstico complejo

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