Extensive intrathoracic and intraperitoneal splenosis mimicking mesothelioma: a case report

Journal of Medical Case Reports

Marcus Both¹  Malte Maria Sieren²  Marcus Seeger³  Rainer Günther³  Bandik Föh⁴ 

[1] Department of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany;Department of Radiology and Nuclear Medicine, University Hospital of Schleswig-Holstein, Ratzeburger Allee 160, 23562, Lübeck, Germany;Hepatology Division, Department of Internal Medicine I, University Hospital of Schleswig-Holstein, Arnold-Heller-Straße 3, Bd. C, 24105, Kiel, Germany;Medical Department I, University Hospital of Schleswig-Holstein, Building A, Ratzeburger Allee 160, 23562, Lübeck, Germany;Institute of Nutritional Medicine, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany;

关键词: Benign tumors;    Case report;    Contrast-enhanced ultrasound;    Mesothelioma;    Splenosis;   

DOI  :  10.1186/s13256-022-03288-9

来源: Springer

【 摘 要 】

BackgroundSplenosis is the heterotopic autotransplantation of splenic tissue after severe splenic trauma and/or splenectomy. The epidemiology is elusive, but splenosis is frequently misdiagnosed as malignant tumors of gastrointestinal, gynecological, or hematological origin before the correct diagnosis is ultimately found. We herein report a rare case of combined, extensive intraabdominal and intrathoracic splenosis initially presenting as pleural mesothelioma.Case presentationA 63-year-old Caucasian male presented with dyspnea and recurring thoracic pain. Initial X-ray and computed tomography scans showed disseminated intrathoracic and intraabdominal lesions. Consequently, thoracoabdominal mesothelioma or a polytopically metastasized cancer of unknown origin was suspected. A thorough examination of the patient’s medical history and contrast-enhanced ultrasound by a skilled examiner revealed the diagnosis of extensive abdominal and thoracic splenosis as a consequence of an abdominal gunshot wound with a ruptured diaphragm several decades earlier. Timely diagnosis by noninvasive measures prevented the patient from potential complications of harmful diagnostic procedures, including nuclear imaging and biopsies. The patient is currently treated for hepatitis C and chronic obstructive lung disease, whereas no specific treatment for splenosis is required.ConclusionsWe present a case of rare intrathoracic and intraperitoneal splenosis mimicking mesothelioma. Contrast-enhanced ultrasound and thorough patient history were used for diagnosis and prevented this patient from having to undergo potentially harmful diagnostics. Splenosis can occur after splenic trauma and, consequently, needs to be considered as a rare differential diagnosis to malignant tumors of various origins when a matching patient history is obtained.

【 授权许可】

CC BY