Hashem Abdelwahab, Elbaset M A, Zahran Mohamed H, Osman Yasser
Urology and Nephrology Center, Mansoura University, Egypt.
Urology and Nephrology Center, Mansoura University, Egypt.
Int J Surg Case Rep. 2018;49:30-33. doi: 10.1016/j.ijscr.2018.05.015. Epub 2018 Jun 5.
Right retroperitoneal splenosis is rare with few reported cases. We report, here, the case of simultaneous peritoneal and retroperitoneal splenosis mimics metastatic right adrenal mass.
A 28-year-old man who had previously undergone post traumatic splenectomy at childhood and subsequently presented with an large incidental non-functioning right adrenal mass with presence of extra-hepatic peritoneal focal lesion diagnosed as metastasis by magnetic resonance imaging (MRI). Adrenalectomy with metatstectomy was performed, and both masses were identified to be splenosis.
Adrenal incidentalomas (AIs) is defined as asymptomatic masses >1 cm. on cross-sectional imaging studies. AIs have significant malignant potential for masses > 6 cm. Splenosis are found most frequently in the left retroperitoneum in cases involving retroperitoneal splenosis. However, right retroperitoneal splenosis have been reported. Traditional imaging techniques cannot differentiate splenosis from malignancy.
Large right adrenal incidentalomas present with other abdominal, peritoneal masses could be splenosis in patient following post-traumatic splenectomy.
右腹膜后脾种植罕见，报道病例较少。在此，我们报告一例同时出现腹膜和腹膜后脾种植，酷似右肾上腺转移瘤的病例。
一名28岁男性，童年时曾接受创伤后脾切除术，随后偶然发现一个巨大的无功能右肾上腺肿块，磁共振成像（MRI）显示肝外腹膜有局灶性病变，诊断为转移瘤。行肾上腺切除术及转移瘤切除术，术后发现两个肿块均为脾种植。
肾上腺偶发瘤（AIs）定义为在横断面成像研究中发现的无症状性肿块>1厘米。对于直径>6厘米的肿块，AIs具有显著的恶性潜能。在涉及腹膜后脾种植的病例中，脾种植最常出现在左腹膜后。然而，也有右腹膜后脾种植的报道。传统成像技术无法区分脾种植和恶性肿瘤。
创伤后脾切除术后患者，出现较大的右肾上腺偶发瘤并伴有其他腹部、腹膜肿块时，可能为脾种植。
