A Case of Posttraumatic Splenosis that was Difficult to Diagnose Preoperatively

Abstract

A 71-year-old man, with a history of splenectomy and left nephrectomy for traffic accident-related splenic and renal injuries at age 18, was referred by his family doctor to our hospital in March 2023 following incidental detection of proteinuria, despite normal renal function, during a medical checkup. Computed tomography revealed a 50 mm mass within the lateral ventral surface of the left lobe of the liver, for which he was referred to the Department of Surgery and, in May 2023, underwent left lateral segmentectomy of the liver for suspected hepatocellular carcinoma. Intraoperative findings revealed a 5 cm mass that extended from the diaphragmatic surface into the lateral segment of the liver and was partially attached to the liver parenchyma ; histopathology revealed that the lesion had a splenic structure. Owing to the history of trauma-induced splenectomy, he was diagnosed with splenosis, which likely occurred following the autotransplantation of splenic tissue that had dispersed into the abdominal cavity during trauma or splenectomy. In this case report, we discuss splenosis, which was diagnosed 53 years after trauma and proved difficult to diagnose preoperatively, with a review of the literature.