Hu Xianwen, Zhao Wei, Wang Pan
Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Front Med (Lausanne). 2025 May 9;12:1578613. doi: 10.3389/fmed.2025.1578613. eCollection 2025.
Splenosis occurring in adrenal glands is relatively rare and is easily misdiagnosed as neoplastic lesions. Herein, we present a case of a 39-year-old woman who underwent a pancreatic tail resection and splenectomy 8 years ago due to caudal pancreatic neuroendocrine tumor and splenic invasion. She underwent abdominal ultrasound examination in an external hospital a month ago due to abdominal discomfort and found a lump in the left adrenal gland. She was admitted to our hospital for further diagnosis and treatment. Abdominal computed tomography (CT) examination revealed a nodule of equal soft tissue density on her left adrenal gland, which presented obvious uniform enhancement on contra-enhanced CT. Subsequently, she underwent fluorine-18 fluorodeoxyglucose (F-FDG) and gallium-68 labeld 1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraaceticacid -D-Phel-Tyr3-Thr8-OC (Ga-DOTATATE) positron emission tomography (PET)/CT imagings, and showed slightly increased F-FDG uptake and obviously increased Ga-DOTATATE uptake in the lesion, suggesting the possibility of neuroendocrine tumor metastasis. However, postoperative pathology confirmed that the lesion was splenosis. Our case suggests that adrenal gland splenosis should be considered as a differential diagnosis of adrenal tumors, understanding the clinical and imaging features of splenosis can reduce misdiagnosis and avoid unnecessary surgical intervention.
肾上腺发生的脾组织异位相对罕见，容易被误诊为肿瘤性病变。在此，我们报告一例39岁女性病例，该患者8年前因胰尾神经内分泌肿瘤伴脾脏侵犯接受了胰尾切除术和脾切除术。一个月前，她因腹部不适在外部医院接受腹部超声检查，发现左肾上腺有一个肿块。她被收治入我院进一步诊断和治疗。腹部计算机断层扫描（CT）检查显示其左肾上腺有一个软组织密度均等的结节，在CT增强扫描时呈现明显均匀强化。随后，她接受了氟-18氟脱氧葡萄糖（F-FDG）和镓-68标记的1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸-D-苯丙氨酸-酪氨酸3-苏氨酸8-奥曲肽（Ga-DOTATATE）正电子发射断层扫描（PET）/CT成像，结果显示病变部位F-FDG摄取略有增加，Ga-DOTATATE摄取明显增加，提示神经内分泌肿瘤转移的可能性。然而，术后病理证实该病变为脾组织异位。我们的病例表明，肾上腺脾组织异位应被视为肾上腺肿瘤的鉴别诊断之一，了解脾组织异位的临床和影像学特征可减少误诊并避免不必要的手术干预。
