Splenosis mimicking metastatic prostate cancer

Case contributed by Dr Jayanth Keshavamurthy

Presentation

CT scan obtained for follow up of prostatectomy for prostate cancer

Patient Data

Age: 65 years
Gender: Male

No spleen is identified in the left upper quadrant.

Two rounded homogeneous soft tissue densities adjacent to the stomach and also in the pelvis are noted.

Left upper quadrant abdominal wall lipoma is incidentally noted.

CT

Annotated images

Arrows point at splenosis.

Nuclear medicine

Sulfur colloid scan

Tracer uptake in the gastric region and in the lower pelvis in the region of the urinary bladder, confirming splenosis.

Sulfur colloid is not excreted by the kidney and urinary bladder.

Case Discussion

When the spleen is not identified always think of trauma and splenectomy. In this case, the patient had a history of abdominal trauma and splenectomy 45 years ago.

The soft tissue densities in the abdomen, and anywhere else in the body, will always have the same density as the native spleen and enhance to the same level.

The sulfur colloid scan and biopsy of the pelvic mass confirmed this as a case of splenosis.

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Case information

rID: 71301
Published: 7th Oct 2019
Last edited: 7th Oct 2019
Inclusion in quiz mode: Included
Institution: Augusta University

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