Enlarged accessory spleen presenting stomach submucosal tumor

Abstract

A 62-year-old man presented with upper abdominal discomfort underwent upper gastrointestinal endoscopy. Gastroscopy and endoscopic ultrasonography revealed a submucosal tumor (SMT) with homogenous echogenicity originated from extragastric organs. An abdominal contrast-enhanced computed tomography (CT) showed that the well-marginated ovoid mass, approximately 6 cm in diameter, enhanced homogenously to a similar degree as splenic parenchyma.99m Technetium sulfur colloid scintigraphy revealed the splenic nature of the mass. A diagnosis of accessory spleen mimicking gastric SMT was made. Subsequent follow-up was uneventful without performing splenectomy.

Accessory spleen misdiagnosed as left adrenal tumor causing complications

“…The accessory spleen is caused by the fusion failure of the splenic anlage located in the dorsal mesogastrium in the fth week of fetal life [4] or developed from the deciduous part of the main spleen [5].…”

Diagnosis of an Accessory Spleen Mimicking a Gastric Submucosal Tumor Using Endoscopic Ultrasonography-guided Fine-needle Aspiration

“…1 Accessory spleens have been reported to mimic gastric SMTs, enlarged lymph nodes, and tumors arising from adjacent organs such as the adrenal gland, pancreas, and kidney. [5][6][7][8][9] Although an accessory spleen is an incidental finding with no clinical significance in most patients, 2,10 they can sometimes become symptomatic due to torsion, spontaneous rupture, hemorrhage and cystic formation. [5][6][7][8] Therefore, detection and characterization can be clinically important, especially in cases such as the present one where the lesion mimicked a gastric SMT.…”

“…1,9,10 CT is an imaging technique commonly used to evaluate gastrointestinal tract diseases including SMT, 11,12 and is useful in making a differential diagnosis of an accessory spleen. 2,10 Accessory spleens appear round or oval, and the attenuation is identical to that of normal splenic parenchyma both before and after administration of contrast medium in CT, 2,10 as observed in the present patient.…”

Accesory Spleen - Incidence, Localization and Clinical Significance

“…It sometimes mimicks in radiological examinations neoplasms of the abdominal organs, for example the pancreas (8-12), the stomach (13) and the left adrenal gland (14) or neoplasms of the retroperitoneal space (15). In 16-21.8% of cases the accessory spleen is located near or in the pancreatic tail so differentiation it from pancreatic neoplasm can be very difficult in a situation like that (4,5,6).…”