Hepatic splenosis mimicking HCC in a patient with hepatitis C liver cirrhosis and mildly raised alpha feto protein: the important role of explorative laparoscopy
Hepatic splenosis mimicking HCC in a patient with hepatitis C liver cirrhosis and mildly raised alpha feto protein: the important role of explorative laparoscopy
Background:
Splenosis is a heterotropic implantation of splenic fragments onto exposed vascularised peritoneal and intrathoracic surfaces, following splenic injury or elective splenectomy.
Case presentation:
A 60 year old cirrhotic patient was referred to us with a hepatic mass, suspected to be HCC in a cirrhotic liver. A computerized tomography scan (CT) demonstrated a
cirrhotic liver with a 2 × 2.7 cm focal hypervascular nodule, lying peripherally at the junction of
segment 7 and 8.
Diagnostic laparoscopy demonstrated a 3 cm exofitic dark brown splenunculus attached to the diaphragm and indenting the surface of segment 7 of the liver. The lesion was easily
resected laparoscopically and shaved from the live surface with no need for a liver resection.
The histopathological assessment confirmed the diagnosis of splenunculus, with no evidence of neoplasia.
Conclusion:
Hepatic splenosis is not a rare event and should be suspected in patients with a history of splenic trauma or splenectomy. Correct diagnosis is essential and will determine subsequent management plans.
In doubtful cases laparoscopic investigation can offere essential information and should be part of the standard protocol for investigating suspected splenosis.
1-4
Abu Hilal, M.
384e1c60-8519-4eed-8e92-91775aad4c47
Harb, A.
e5efdb5c-cb37-4cae-b444-5769e1c9cc12
Zeidan, Bashar A.
acd18415-22ee-43b8-a102-a36ea22dd0af
Steadman, B.
f98d0e8a-7204-4995-af15-7f61bc832b05
Primrose, J.N.
d85f3b28-24c6-475f-955b-ec457a3f9185
Pearce, N.W.
27eb0204-f8de-48bf-945b-02003799af54
5 January 2009
Abu Hilal, M.
384e1c60-8519-4eed-8e92-91775aad4c47
Harb, A.
e5efdb5c-cb37-4cae-b444-5769e1c9cc12
Zeidan, Bashar A.
acd18415-22ee-43b8-a102-a36ea22dd0af
Steadman, B.
f98d0e8a-7204-4995-af15-7f61bc832b05
Primrose, J.N.
d85f3b28-24c6-475f-955b-ec457a3f9185
Pearce, N.W.
27eb0204-f8de-48bf-945b-02003799af54
Abu Hilal, M., Harb, A., Zeidan, Bashar A., Steadman, B., Primrose, J.N. and Pearce, N.W.
(2009)
Hepatic splenosis mimicking HCC in a patient with hepatitis C liver cirrhosis and mildly raised alpha feto protein: the important role of explorative laparoscopy.
World Journal of Surgical Oncology, 7 (1), .
(doi:10.1186/1477-7819-7-1).
Abstract
Background:
Splenosis is a heterotropic implantation of splenic fragments onto exposed vascularised peritoneal and intrathoracic surfaces, following splenic injury or elective splenectomy.
Case presentation:
A 60 year old cirrhotic patient was referred to us with a hepatic mass, suspected to be HCC in a cirrhotic liver. A computerized tomography scan (CT) demonstrated a
cirrhotic liver with a 2 × 2.7 cm focal hypervascular nodule, lying peripherally at the junction of
segment 7 and 8.
Diagnostic laparoscopy demonstrated a 3 cm exofitic dark brown splenunculus attached to the diaphragm and indenting the surface of segment 7 of the liver. The lesion was easily
resected laparoscopically and shaved from the live surface with no need for a liver resection.
The histopathological assessment confirmed the diagnosis of splenunculus, with no evidence of neoplasia.
Conclusion:
Hepatic splenosis is not a rare event and should be suspected in patients with a history of splenic trauma or splenectomy. Correct diagnosis is essential and will determine subsequent management plans.
In doubtful cases laparoscopic investigation can offere essential information and should be part of the standard protocol for investigating suspected splenosis.
This record has no associated files available for download.
More information
Published date: 5 January 2009
Identifiers
Local EPrints ID: 144847
URI: http://eprints.soton.ac.uk/id/eprint/144847
PURE UUID: 593c91f3-89d8-4447-9e1e-43e50e2f9c8d
Catalogue record
Date deposited: 15 Apr 2010 10:19
Last modified: 23 Jul 2022 01:38
Export record
Altmetrics
Contributors
Author:
M. Abu Hilal
Author:
A. Harb
Author:
Bashar A. Zeidan
Author:
B. Steadman
Author:
N.W. Pearce
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics