Matsuzawa Hirokazu, Munakata Shinya, Momose Hirotaka, Tsuchiya Yuki, Ishiyama Shun, Kamiyama Hirohiko, Takahashi Makoto, Sakamoto Kazuhiro
Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Case Rep Gastroenterol. 2019 Dec 19;13(3):539-543. doi: 10.1159/000504433. eCollection 2019 Sep-Dec.
Huge accessory spleen (AS) is a rare condition difficult to diagnose. We recently treated a Japanese woman with a progressive huge AS. She had a history of aortic valve replacement for aortic stenosis 1 month prior. At that time, a 4-cm AS had been detected by the preoperative computed tomography (CT). This mass was a progressive tumor which grew to 7 cm over the course of 3 months. Thus, we performed surgery with a preoperative diagnosis of huge AS by CT and positron emission tomography. A laparoscopic resection was performed considering the risk of torsion, spontaneous rupture, or hemorrhage. The final pathological diagnosis was AS. This is the first reported case in the English literature of progressive AS with no symptoms at the initial presentation that was treated with laparoscopic resection.
巨大副脾是一种罕见且难以诊断的病症。我们最近治疗了一名患有进行性巨大副脾的日本女性。她在1个月前因主动脉瓣狭窄接受了主动脉瓣置换术。当时,术前计算机断层扫描(CT)检测到一个4厘米的副脾。这个肿块是一个进行性肿瘤,在3个月内长到了7厘米。因此,我们通过CT和正电子发射断层扫描进行术前诊断为巨大副脾后进行了手术。考虑到扭转、自发性破裂或出血的风险,我们进行了腹腔镜切除术。最终病理诊断为副脾。这是英文文献中首次报道的初始表现无症状的进行性副脾经腹腔镜切除治疗的病例。