Thoracic splenule without prior history of trauma or surgery

Abstract

ctopic extra-abdominal splenic tissue is a rare clinical condition. Most frequently, it is caused by splenosis, which is defined as the autotransplantation of splenic tissue after disruption of the splenic capsule. It occurs more commonly in the peritoneum, omentum, and the mesentery, whereas thoracic splenosis has always been documented after trauma or abdominal surgery, especialy after splenectomy. However, splenic tissue in the thorax that is perfused by thoracic vessels, without trauma or abdominal surgery, can be present as an embryologic anomaly and is an exceptionally unusual situation. We report a case of thoracic splenule without any of the above-mentioned provocative factors misdiagnosed as a thoracic mass. To our knowledge, this is the second case to be reported. 1

Congenital intrathoracic accessory spleen is a very rare trick of nature: a case report

“…Sequestration and malignancy were the leading differential diagnoses [2,4]. As such, CT scan alone may not reliably diagnose CIAS and distinguish it from sequestration [3,5]. More specific methods of identifying CIAS on imaging include ferumoxide enhanced MRIs, and noninvasive nuclear scintigraphy [3,5].…”

“…As such, CT scan alone may not reliably diagnose CIAS and distinguish it from sequestration [3,5]. More specific methods of identifying CIAS on imaging include ferumoxide enhanced MRIs, and noninvasive nuclear scintigraphy [3,5]. Interestingly, in two studies where preoperative biopsies were performed, the pathology was inconclusive [1,2].…”

“…CIAS is extremely rare, and only four reports exist in the literature. To our knowledge, no cases have been reported from the United States to date [2,3].…”

“…In clinical practice, CIAS may pose a diagnostic dilemma [3]. Furthermore, in cases of hematologic disorders such as idiopathic thrombocytopenic purpura (ITP), a missed splenic tissue such as CIAS may result in relapse [3].…”

“…In clinical practice, CIAS may pose a diagnostic dilemma [3]. Furthermore, in cases of hematologic disorders such as idiopathic thrombocytopenic purpura (ITP), a missed splenic tissue such as CIAS may result in relapse [3]. As such, we sought to highlight an interesting case of CIAS, and raise awareness about crucial aspects of its presentation based on a review of the literature.…”