A Case of Splenosis Presenting as a Peritoneal Mass More Than 30 Years After Post-traumatic Splenectomy

Abstract

A male in his 50s with a history of splenectomy due to trauma performed for traumatic injury of the spleen was referred to our hospital from a local clinic for evaluation and treatment of appetite loss. Contrast-enhanced abdominal CT showed homogeneously enhancing peritoneal masses on both sides either side of the umbilicus. On abdominal ultrasound, the masses were hypoechoic. Suspecting an intra-abdominal malignancy based on the imaging findings, we performed a laparoscopic tumor biopsy to obtain a histopathological diagnosis. The masses were dark red, highly vascular, and embedded in the abdominal wall, covered by the omentum. Postoperative histopathological examination confirmed splenic tissue containing red and white pulp. Based on the previous history of abdominal trauma, we made the diagnosis of splenosis. The patient showed a favorable postoperative course and was discharged on the sixth postoperative day. This case highlights an instance of splenosis that needed to be differentiated from intra-abdominal malignancy. Splenosis is often discovered as an incidentaloma. While a history of splenic trauma or splenectomy may allow for a facilitate diagnosis via non-invasive testing, laparoscopic biopsy is a useful, minimally invasive diagnostic approach when a definitive diagnosis cannot be made by non-invasive testing.