Metastatic malignancy mimics: a rare case of traumatic splenosis mimicking intra-abdominal malignancy

We present a case of a patient, undergoing imaging for an unrelated presentation, whose adolescent abdominal trauma had caused an unrecognised disseminated intra-abdominal splenosis, resulting in an imaging presentation on CT that suggested intra-abdominal malignancy. The lack of correlative symptom...

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Bibliographic Details
Published in:BMJ case reports 2020-02, Vol.13 (2), p.e232043
Main Authors: Nadesalingam, Vinoth, Davis, Laura May, Vivian, Gill, Corcoran, Benjamin
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Injuries - diagnostic imaging
Abdominal Neoplasms
Blood
Case reports
Coronary vessels
Diagnosis, Differential
Gamma rays
Gastric cancer
haematology (incl blood transfusion)
Humans
Labeling
Liver
Male
Middle Aged
Neoplasm Metastasis
Patients
radiology
Reminder of Important Clinical Lesson
Spleen
Splenosis - diagnostic imaging
Teenagers
Tomography, Emission-Computed, Single-Photon
Trauma
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Summary:We present a case of a patient, undergoing imaging for an unrelated presentation, whose adolescent abdominal trauma had caused an unrecognised disseminated intra-abdominal splenosis, resulting in an imaging presentation on CT that suggested intra-abdominal malignancy. The lack of correlative symptoms of disseminated malignancy, in addition to imaging findings suggesting previous upper abdominal trauma, led to a suggestion that the intra-abdominal lesion might represent spleen tissue. A denatured red cell scan with radio-labelled technetium-99m, allowed this tissue to be confirmed as splenic in nature, and an invasive, and potentially risky biopsy was averted.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2019-232043