Diffuse Abdominal Splenosis Mimicking Peritoneal Metastases in a 35-Year-Old Man with a Resectable Carcinoma of the Ampulla of Vater

Abstract

A 35-year-old man with a history of blunt abdominal trauma and splenic rupture was diagnosed with an ampullary adenocarcinoma. At workup, a CT scan showed multiple intra-abdominal lesions similar to peritoneal carcinosis, and the patient was referred for palliative chemotherapy. On clinical suspicion, however, a biopsy was performed on an intra-abdominal lesion, establishing the diagnosis of abdominal splenosis. A radical pancreaticoduodenectomy ad modum Whipple was performed, followed by adjuvant chemotherapy with gemcitabine. At the 18-month follow-up, the patient was free from recurrent disease. We conclude that splenosis should be considered as a differential diagnosis of peritoneal metastases in cancer patients with a history of abdominal trauma and/or splenectomy. Other reports on splenosis in cancer patients and diagnostic workup are discussed.

Imaging Diagnosis—ectopic Spleen Mimicking Hepatic Tumor With Intra‐abdominal Metastases Investigated via Triple‐phase Helical Computed Tomography in a Dog

“…In humans, ectopic spleen reportedly presents as a mass with CT findings similar to normal splenic tissue. 2,9 However, splenosis has been confused with other abdominal masses in some cases, based on contrast CT. [10][11][12][13][14] In these cases, the contrast pattern mimicked hepatic masses such as hepatocellular carcinoma and hepatic adenoma. 14 To our knowledge, the CT findings of ectopic spleen in dogs have not been reported.…”

“…In humans, the most common sites of splenosis are areas of the abdominal cavity including the serosa of the intestinal tract and the omentum. Occurrences of splenosis have also been reported in the liver, kidney, pancreas, thoracic cavity, and intracranially . In dogs, cases of ectopic spleen associated with the liver, mesentery, and pancreas have been reported .…”

“…In humans, the mean diameters of reported cases of accessory spleen range from 10.3 to 16.8 mm, and the maximum diameter reported is 79 mm . The reported diameters of splenosis range from 1 mm to 7 cm . In dogs, the diameters of the ectopic spleens reported are also various, and the maximum diameter reported to date is 11.2 cm .…”

“…Occurrences of splenosis have also been reported in the liver, kidney, pancreas, thoracic cavity, and intracranially. [3][4][5][10][11][12][13][14]16,17 In dogs, cases of ectopic spleen associated with the liver, mesentery, and pancreas have been reported. [18][19][20] In humans, it has also been reported that multifocal splenosis can mimic metastasis and multiple malignant tumors including malignant lymphoma.…”

Splenosis Mimicking Peritoneal Implants in a Female with Ovarian Cystic Masses: A Case Report

“…Splenosis may be found incidentally in an asymptomatic patient or could complicate a diagnosis by mimicking malignant conditions such as peritoneal carcinomatosis. Based on the author's literature search, cases have previously been published where splenosis mimicked peritoneal metastases from non-ovarian primary abdominal tumors [10][11][12][13][14]. To best of our knowledge, this is the first case to describe splenosis mimicking malignant spread in complex ovarian masses.…”