Gastric Splenosis Mimicking Gastrointestinal Stromal Tumor

Abstract

Translocation of splenic tissue in patients after traumatic spleen injury or splenectomy is called splenosis. Gastric splenosis is a rare presentation that can be mistaken for gastrointestinal stromal tumor (GIST). Patients are usually asymptomatic and do not require surgical intervention. In this report, we present a case of a 68-year-old male patient with a previous history of surgical splenectomy after traumatic splenic rupture, who underwent routine upper endoscopy for the evaluation of dysphagia. An endoscopic exam of the stomach revealed an incidental finding of a submucosal gastric nodule. On endoscopic ultrasound exam, the lesion was found to be suggestive of GIST originating from layer 4. A core biopsy was obtained from the nodule, which was consistent with gastric splenosis. The differentiation of gastric splenosis from other gastric lesions such as GIST is important since asymptomatic patients with gastric splenosis do not need to undergo surveillance or surgical resection. It should be suspected especially in patients with a history of splenectomy or splenic rupture. Endoscopic ultrasound (EUS)-guided core biopsy can help confirm the diagnosis and differentiate the condition from GIST.

Splenosis mimicking gastric obstructive tumor: Diagnostic workup and surgical excision

“…FNB can provide a more definitive diagnosis. CD8 immunostaining of cell block or core biopsy material highlights unique splenic endothelial cells and confirms the diagnosis of splenosis 11 . This marker has been reported to provide the diagnosis of accessory spleen in the pancreas thru EUS‐guided FNA in a limited series of patients 12 …”

A large gastric splenosis mimicking gastrointestinal stromal tumor: A case report and literature review

“…S1. The first author, publication year and country of each case, along with the patient's age, gender, main clinical symptoms, medical history, lesion size and findings from gastroscopic, ultrasonic and CT imaging, were meticulously recorded, as depicted in Table I (4,6,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Through a systematic search, a total of 22 cases of gastric splenosis and intragastric splenosis were definitively confirmed from the published literature.…”