Splenosis - history of uterine leiomyosarcoma

Case contributed by Michael P Hartung


Surveillance imaging after resection of uterine leiomyosarcoma.

Patient Data

Age: 50 years
Gender: Female

Lobulated left upper quadrant masses in the splenectomy bed. Small nodules along the lateral left hepatic lobe, mid abdominal omentum, medial left rectus abdominis muscle. 

Tc-99m labeled RBC

Tc99m heat-damaged RBC scan shows normal uptake in the liver and uptake in several of the larger masses, confirming reticuloendothelial activity of splenic tissue. 

Case Discussion

This patient had a remote history of abdominal trauma and splenectomy. This is her first scan after hysterectomy where a low-grade leiomyosarcoma was detected. While the left upper quadrant tissue is not as alarming or easy to confuse for malignancy, the smaller peritoneal nodules can be. Thus, is it important to remember this possibility in patients with history of splenic trauma/splenectomy. Nuclear medicine studies such as sulfur colloid or heat-damaged RBC scans can be helpful to problem solve. 

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