Liu Ming, Zhang Miao, Xiang Jingyu, Zhang Yifang, Liu Jian
Department of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical University, Bengbu 233004, Anhui, China.
Case Rep Med. 2025 Aug 29;2025:4875687. doi: 10.1155/carm/4875687. eCollection 2025.
Ectopic spleen (ES) is a rare complication of autologous transplant following spleen injury. Autopsy studies suggest that the true incidence rate could be as high as 67%, though only 5%-10% of patients require clinical intervention. This case report describes a highly cautionary case of ES, with an extremely long latent period. The patient presented with dull lower abdominal pain 24 years after undergoing a splenectomy. An ultrasound examination revealed a round-shaped, solid mass measuring 1.6 × 2.5 cm adjacent to the right ovary. Following laparoscopic surgery, a 2.5 × 1.5 cm mass on the surface of the sigmoid colon and a 1.0 cm dark red nodule on the pelvic floor were completely removed. Pathological and immunohistochemical examinations confirmed that both lesions were splenic tissue. This case highlights the fact that the latent period of ES can last for decades. For patients with a history of splenectomy, any new pelvic or abdominal masses should be included in the differential diagnosis of ES. We urge the implementation of standardized long-term follow-up mechanisms combined with multimodal imaging techniques for a comprehensive assessment in order to effectively avoid misdiagnosis and overtreatment.
异位脾（ES）是脾损伤后自体移植的一种罕见并发症。尸检研究表明，其实际发病率可能高达67%，尽管只有5%-10%的患者需要临床干预。本病例报告描述了一例具有高度警示意义的ES病例，其潜伏期极长。该患者在脾切除术后24年出现下腹部隐痛。超声检查发现右卵巢旁有一个1.6×2.5厘米的圆形实性肿块。腹腔镜手术后，乙状结肠表面一个2.5×1.5厘米的肿块和盆底一个1.0厘米的暗红色结节被完全切除。病理和免疫组化检查证实这两个病变均为脾组织。该病例突出了ES潜伏期可长达数十年这一事实。对于有脾切除病史的患者，任何新出现的盆腔或腹部肿块都应纳入ES的鉴别诊断。我们敦促实施标准化的长期随访机制，并结合多模态成像技术进行全面评估，以有效避免误诊和过度治疗。
