Preview

Surgery and Oncology

Advanced search

Abdominal peritoneal splenosis (clinical case)

https://doi.org/10.17650/2949-5857-2023-13-3-57-64

Abstract

Background. Splenosis, or heterotopic autotransplantation of spleen tissue, is a benign disease, occurring in patient after splenectomy. This formation demands correct differential diagnosis because it is often diagnosed as a tumor. Main methods of splenosis diagnosis are ultrasound inspection, CT, MRI, but detailed anamnesis is also important to set the correct diagnosis. The clinical case in this report is aimed to show importance of timely and correct diagnosis which will allow to avoid unnecessary invasive diagnostic procedures, late diagnosis and decreasing of medical assistance quality.
Clinical case. patient 61 y. o. is suspected on a tumor in left iliac region. He noted the trauma after falling on a back. The inspection was performed: CT of iliac region showed formation in the small intestines. Splenectomy was carried out 20 years ago. The patient is set to the clinical medical center “Medicinsky gorod” to a surgeon-oncologist. physical examination and laboratory analysis showed no pathological changes. CT of abdominal organs showed formation with regular edges. MRI of pelvic organs with contrast agent showed formation accumulating contrast irregularly. Control CT of abdominal organs showed no increasing of formation size.
Conclusion. Abdominal splenosis is a benign disease, occurring after spleen tissue implantation in the abdominal cavity after spleen trauma or splenectomy. Splenosis course is usually asymptomatic and it is often diagnoses as a peritoneal canceromatosis mistakenly. Splenosis has to be included in the differential diagnosis in patients with trauma or splenectomy in anamnesis.

About the Authors

S. A. Zvezda
Multidisciplinary clinical medical center “Medical City”; Tyumen State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation

Sergey Aleksandrovich Zvezda

32 St. Barnaulskaya, Tyumen 625041

54 St. Odesskaya, Tyumen 625023



R. I. Tamrazov
Multidisciplinary clinical medical center “Medical City”; Tyumen State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation

32 St. Barnaulskaya, Tyumen 625041

54 St. Odesskaya, Tyumen 625023



N. M. Fedorov
Multidisciplinary clinical medical center “Medical City”; Tyumen State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation

32 St. Barnaulskaya, Tyumen 625041

54 St. Odesskaya, Tyumen 625023



L. N. Komarova
Tyumen State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation

54 St. Odesskaya, Tyumen 625023



E. M. Frank
Multidisciplinary clinical medical center “Medical City”
Russian Federation

32 St. Barnaulskaya, Tyumen 625041



D. G. Dimitriadi
Tyumen State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation

54 St. Odesskaya, Tyumen 625023



R. D. Novikov
Kurgan Regional Clinical Hospital
Russian Federation

63 St. Tomina, Kurgan 640002



D. S. Butenko
Tyumen State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation

54 St. Odesskaya, Tyumen 625023



S. I. Gudz
Tyumen State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation

54 St. Odesskaya, Tyumen 625023



References

1. Buttar S.N., Ravn J. Intrathoracic splenosis without clinical evidence of diaphragmatic rupture. Ann Thorac Surg 2019;108(4):221–2. DOI: 10.1016/j.athoracsur.2019.01.083

2. Buchbinder J.H, Lipkoff C.J. Splenosis: multiperitoneal splenic implant following abdominal injury: a report of a case and review of the literature. Surgery 1939;6:927–34.

3. Fleming C.R., Dickson E.R., Harrison E.G. Splenosis: autotransplantation of splenic tissue. Am J Med 1976;61:414–9.

4. Vercher-Conejero J.L., Bello-Arques P., Pelegri-Martinez L. et al. Abdominal splenosis: an often underdiagnosed entity. Revista Española de Medicina Nuclear (English Edition) 2011;30(2):97–100. DOI: 10.1016/S1578-200X(11)70013-4

5. Bogomolov O., Shkolnik M., Stanjevsky A. et al. Diagnosis and treatment of patient with right kidney cancer with disseminated retroperitoneal splenosis. Voprosy onkologii = Oncology issues 2018;64(4):533–8 (In Russ.). DOI: 10.37469/0507-3758-2018-64-4-533-538

6. Tandon Y.K., Coppa C.P., Purysko A.S. Splenosis: a great mimicker of neoplastic disease. Abdominal Radiology 2018;43(11):3054–59. DOI: 10.1007/s00261-018-1601-5

7. Degheili J.A., Abou Heidar N.F. Pelvic splenosis – a rare cause of pelvic mass. Clin Case Rep 2019;7(11):2247–49. DOI: 10.1002/ccr3.2419

8. Vernuccio F., Dimarco M., Porrello G. et al. Abdominal splenosis and its differential diagnoses: What the radiologist needs to know. Curr Probl Diagn Radiol 2021;50(2):229–35. DOI: 10.1067/j.cpradiol.2020.04.012

9. Fayazov R.R., Akbulatova N.A., Timerbulatov Sh. V. et al. Splenosis in surgical practice. Meditsinskaya nauka i obrazovanie Urala = Medical science and education of Ural region 2008;9(3):128–30 (In Russ.).

10. Zubov A.D., Litvin A.A., Gubergrits N.B. et al. Progressive multiple splenosis: view of literature and proper inspection. Vestnik Baltiyskogo federalnogo universiteta imeni I. Kanta. Seriya: Estestvennye i meditsinskye nauki = Journal of Baltic Federal University named after I. Kant. Section: natural and medical science 2020;4:104–17 (In Russ.).

11. Timerbulatov Sh.V., Ahmerov R.R., Timerbulatov M.V. et al. Peritoneal splenosis, simulating canceromatosis. Vestnik khirurgii imeni I.I. Grekova = Surgery journal named after I.I. Grekov 2020:179(3):91–4. (In Russ.). DOI: 10.24884/0042-4625-2020-179-3-91-94

12. Erxleben C., Scherer R., Elgeti T. Diagnosis: splenosis. Deutsches Ärzteblatt International 2018;115(47):792. DOI: 10.3238/arztebl.2018.0792

13. Martín-Marcuartu J.J., Fernandez-Rodriguez P., Tirado-Hospital J.L. et al. Labeled heat-denatured red blood cell scintigraphy in hepatic splenosis in a cirrhotic patient. Cirugia espanola 2020;98(3):158. DOI: 10.1016/j.ciresp.2019.04.014

14. Nadesalingam V., Davis L.M., Vivian G. et al. Metastatic malignancy mimics: a rare case of traumatic splenosis mimicking intra-abdominal malignancy. BMJ Case Rep 2020;13(2): e232043. DOI: 10.1136/bcr-2019-232043

15. Zinovyev A.V., Kryuchkova O.V., Markina N.Y. Splenosis – formation in the left hypochondrium. Dokazatelnaya gastroenterologia = Evidence-based gastroenterology 2013;2(4):58–62 (In Russ.).

16. Ivanov M.I. Extraorganic bleeding of additional spleen lobules. Universitetskaya meditsina Urala = University medicine of Ural region. 2020;6(1):34–5 (In Russ.).

17. Lake S.T., Johnson P.T., Kawamoto S. et al. CT of splenosis: patterns and pitfalls. Am J Roentgenol 2012;199(6):686–93. DOI: 10.2214/AJR.11.7896

18. El-Kheir A., Abdelnour M., Boutros J.G. Simultaneous small bowel and colon obstruction due to splenosis. A case report and review of literature. Int J Surg Case Rep 2019;58:63–6. DOI: 10.1016/j.ijscr.2019.03.040

19. Strokin K.N., Chemezov S.V. Ectopy spleen tissue after splenectomy (clinical case). Orenburgsky meditsinsky Vestnik = Orenburg Medical Journal 2017;2(18):50–1 (In Russ.).

20. Short N.J., Hayes T.G., Bhargava P. Intra-abdominal splenosis mimicking metastatic cancer. Am J Med Sci 2011;341(3):246–9. DOI: 10.1097/maj.0b013e318202893f

21. Braga J., Pereira F., Fernandes C. et al. Abdominal splenosis mimicking a colon tumour. Eur J Case Rep Intern Med 2021;8(1): 002219. DOI: 10.12890/2021_002219

22. Kefeli U., Mehtap O., Cakir O. et al. Follicular lymphoma in a patient with splenosis: a case report. J Int Med Res 2020;48(3):300060519890200. DOI: 10.1177/0300060519890200

23. Pichon L., Lebecque O., Mulquin N. Splenosis mimicking peritoneal carcinomatosis. JBR-BTR 2020;104(1):14. DOI: 10.5334/jbsr.2089

24. Gordeev S.S., Magarramova Z.N., Myshlyakov V.S. et al. Rare malignant tumors in clinical oncoproctology: a single-center 20 years retrospective analysis. Povolzhskij onkologicheskij vestnik = Povolzhsky Oncology Bulletin 2022;13(4):31–7 (In Russ.). DOI: 10.32000/2078-1466-2022-4-31-37

25. Gordeev S.S., Rybakov E.G., Karachun A.M. et al. The optimal surgical volume for anorectal melanoma: a retrospective analysis of the Russian colorectal cancer society registry. Tazovaya hirurgiya i onkologiya = Surgery and Oncology 2022;12(4):11–8 (In Russ.). DOI: 10.17650/2686-9594-2022-12-4-11-18


Review

Views: 1162


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2949-5857 (Online)