Splenic lesion mimicking breast metastasis: The first description of splenic parenchymal endometriosis

Ariane Weyl, Claire Illac, M.-C. Delchier, Marie-Charlotte Delchier, Bertrand Suc, Emmanuel Cuellar, Élodie Chantalat, Elodie Chantalat
Journal of Endometriosis and Pelvic Pain Disorders · 2020 · vol. 13(1) , pp. 69–73 · doi:10.1177/2284026520960846 · W3092955969
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Researchers describe the first case of splenic parenchymal endometriosis, initially mimicking breast metastasis on CT scans and responding to cancer-directed therapies before definitive diagnosis via splenectomy.

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Abstract

Introduction: Splenic parenchymal endometriosis has never been described to date. We report here the case of real parenchymal endometriosis of the spleen. Case description: In this case, a 54-year-old female patient presented a histologically proven metastatic recurrence of breast cancer in the internal breast chain. The CT-scan also detected a large cystic structure developed from the spleen, but non-suspected to be metastasis. The patient was treated with chemotherapy (paclitaxel) and a combination of targeted therapies (everolimus and trastuzumab). While a complete radiological and biological response was noted at 2 months, the splenic cyst gradually decreased over the years. When targeted therapies were stopped, a reincrease of the splenic lesion and de novo significant hypermetabolism of the splenic parenchyma on 18F-FDG PET scan were observed. A splenectomy was finally performed and revealed splenic parenchymal endometriosis. Conclusion: This case once again highlights the complexity of endometriosis disease, from a pathophysiological point of view, but also the difficulties of radiological characterisation, and diagnostic management.

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endometriosis

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