A pelvic mass with final diagnosis of spontaneous splenosis in patient with previous splenectomy: a case report

Abstract

Introduction: Spleen is an immunologic organ and has critical role in prevention of capsulated microorganism infection. Accessory spleen after splenectomy is important due to this immunologic effect. On the other hand, accessory spleens should be considered in differential diagnosis of abdomino-pelvic masses. In this report, we present a rare case of pelvic mass with final diagnosis of autoimplantationof accessory spleen on the mesentery of the rectum. Case presentation: The patient was a 32-year-old nulligravidarum woman with history of primary infertility and previous splenectomy due to spleen trauma in childhood without the history of hospitalization due to infection. The imaging results showed solid and hypervascular pelvic mass following IVF assessment. The patient was admitted in Gynecology Oncology Surgery Section in Emam Khomeini hospital, Tehran University of Medical Sciences. She underwent laparotomy, and the result due to the frozen section pathology, was reported as accessory spleen. Conclusion: Abdominopelvic masses with normal serum tumor marker, especially in patient with previous trauma and splenectomy, should be considered in differential diagnosis of accessory spleens, and should be confirmed with exact assessment by nuclear scan or laparoscopy, so that by accidental resection of these kind of masses the immunological safety of patients wouldn't be at risk.

Keywords

• pelvic neoplasms
• spleen
• splenectomy
• splenosis