[A case of intrahepatic splenosis]

Abstract

When a 32-year-old man was 18 a traffic accident caused splenic rupture, for which he underwent splenectomy, complicated postoperatively by hepatitis. As part of routine follow-up with his family doctor for chronic hepatitis C, a hepatic tumor was detected on plain abdominal computed tomography (CT), and he was admitted to our hospital for further investigation and treatment. Based on the results of abdominal dynamic CT, abdominal magnetic resonance imaging(MRI), abdominal angiography, CT during hepatic arteriography (CTHA) and CT during arterial portography (CTAP), we performed a laparotomy for suspected hepatocellular carcinoma. The operative findings were a 40 mm dark purple-brown nodule on the surface of the S7 segment of the liver, as well as multiple nodules, less than 20 mm in size but otherwise of similar appearance, scattered over the abdominal viscera and peritoneum, in particular the greater omentum. A hepatectomy was not performed, as we considered this to be a case of intrahepatic splenosis, so the abdomen was closed after a liver biopsy was taken. Histopathological examination of this specimen confirmed the diagnosis. As there have been only 19 previous reported cases of intrahepatic splenosis, we hereby present this valuable case with a review of the literature.