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World J Surg Oncol. 2018 Jun 28;16(1):119. doi: 10.1186/s12957-018-1419-1.

Management of intrahepatic splenosis:a case report and review of the literature.

Xuan Z1,2, Chen J1,2, Song P1,2, Du Y1,2, Wang L3, Wan D1, Zheng S4,5.

Author information

1
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China.
2
Collaborative innovation center for Diagnosis treatment of infectious diseases, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China.
3
Department of Pathology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China.
4
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China. shusenzheng@zju.edu.cn.
5
Collaborative innovation center for Diagnosis treatment of infectious diseases, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China. shusenzheng@zju.edu.cn.

Abstract

BACKGROUND:

Splenosis is the heterotopic autotransplantation and implantation of splenic tissue after splenic trauma or splenectomy. Considering that splenosis often occurs in the mesentery, omentum, and peritoneum, intrahepatic splenosis has seldom been reported. We report a rare case of isolated intrahepatic splenosis in a 54-year-old man who presented with a liver mass thought to be hepatocellular carcinoma.

CASE PRESENTATION:

A 54-year-old man was referred to our hospital for further evaluation of a liver lesion. The patient was asymptomatic and had a history of emergent splenectomy after a high-altitude falling accident. Abdominal contrast-enhanced computed tomography revealed a 4.5 × 3.3 cm lesion that was located in segment IV of the left liver lobe. The lesion had an inhomogeneous enhancement during the arterial phase and diminished enhancement during the portal and equilibrium phases. Similar radiological features were also observed on a contrast magnetic resonance imaging scan. Partial hepatectomy was performed with the suspicion of hepatocellular carcinoma. Pathological examination of the liver specimen revealed intrahepatic splenosis.

CONCLUSION:

Splenosis should be considered in differential diagnosis of a liver mass discovered years after splenic trauma or surgery. A proposed scoring system may be helpful in evaluating the suspicious degree of intrahepatic mass to be splenosis. Invasive treatments are not recommended for asymptomatic patients, since the splenosis can provide beneficial immunologic function.

KEYWORDS:

Intrahepatic splenosis; Liver neoplasm; Splenectomy; Trauma

PMID:
29954390
PMCID:
PMC6022698
DOI:
10.1186/s12957-018-1419-1
[Indexed for MEDLINE]
Free PMC Article

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