Porwal Rekha, Singh Amit, Jain Pritesh
Professor and Head, Department of General Surgery, Jawahar Lal Nehru Medical College , Ajmer, Rajasthan, India .
Assistant Professor, Department of General Surgery, Jawahar Lal Nehru Medical College , Ajmer, Rajasthan, India .
J Clin Diagn Res. 2015 Jun;9(6):PD07-8. doi: 10.7860/JCDR/2015/13229.6120. Epub 2015 Jun 1.
Accessory spleen may be formed during defective embryonic development. The retroperitoneal accessory spleen is a rare clinical entity and metastasis of renal carcinoma into this entity is extremely rare. We are presenting a case of a 50-year-old male patient who was admitted with complaints of left lower abdominal lump and pain. The computed tomography revealed a 7×4 cm mass at upper pole of left kidney. To rule out malignancy, we planned for surgical exploration. Suprarenal mass was densely adherent to left kidney so left nephouroureterectomy with suprarenal mass was performed. On histopathology examination left kidney showed transitional cell carcinoma with metastasis into suprarenal mass that was found to be an accessory spleen. Diagnosis was made retrospectively by histopathological observation. So this case highlights the difficulty in differentiation of these masses from malignant adrenal tumours.
副脾可能在胚胎发育缺陷时形成。腹膜后副脾是一种罕见的临床实体,肾癌转移至该实体极为罕见。我们现报告一例50岁男性患者,因左下腹部肿块及疼痛入院。计算机断层扫描显示左肾上极有一个7×4 cm的肿块。为排除恶性肿瘤,我们计划进行手术探查。肾上腺肿块与左肾紧密粘连,因此行左肾输尿管切除术及肾上腺肿块切除术。组织病理学检查显示左肾为移行细胞癌,转移至肾上腺肿块,而该肿块被发现是一个副脾。通过组织病理学观察进行回顾性诊断。所以该病例凸显了将这些肿块与恶性肾上腺肿瘤区分开来的困难。