Case report: abdominal splenosis

Introduction (case reports only) Splenosis is a benign condition that can manifest after trauma or surgery involving the spleen. It is an auto-transplantation of splenic tissue and has been observed in the abdominal, thoracic cavities and subcutaneously. Splenosis is usually found on radiological examination, during surgery and in most cases is asymptomatic. Treatment is only required if a patient complains of abdominal pain, obstruction or bleeding. On radiological examination splenosis can be similar to a metastatic malignant disease, endometriosis and other tumors depending on its location and distribution. Case description (case reports only) A 34 year old female patient complained of dull, intermittent pain in the lower right quadrant of the stomach. The intensity of the pain was 2-3 on the scale from 1 to 10, over the course of the previous month the pain had intensified. The patient reported to have had a splenectomy in 1991. During an ultrasound a solid mass (47x42mm) was observed posteriorly to the right of the uterus. The structure had medium vascular density and was reminiscent of the endometrium. A similar mass was observed during an examination 1 year prior. During an MRI a pathological tumor of the uterus-cervix junction was suspected. A laparoscopy to extirpate the tumor was performed. The histological results showed splenic tissue. Summary (case reports only) We report a case of a female patient, who complained about abdominal pain. Patient reported to have had a splenectomy in 1991. On radiological examination a solid mass was observed by the uterus. The histological results showed splenic tissue. Conclusions It is important to know the patient's medical history concerning splenic trauma or splenectomy. In all patients with such history, splenosis should be on the differential diagnosis if tumors are present in the abdominal, pelvic or thoracic cavities, especially when systemic symptoms are absent, in order to avoid unnecessary intervention or medication.