@2024 Afarand., IRAN
ISSN: 2251-8215 Sarem Journal of Reproductive Medicine 2018;2(3):
ISSN: 2251-8215 Sarem Journal of Reproductive Medicine 2018;2(3):
Pelvic Splenosis Mimicking Endometriosis; Dysmenorrhea an Endometrioma-like Mass in Sonography
ARTICLE INFO
Article Type
Case ReportAuthors
Saremi A.T. (*)Zamanian M. (1)
Soltani L. (1)
Pooladi A. (2)
(*) “Sarem Fertility & Infertility Research Center (SAFIR)” and “Sarem Cell Research Center (SCRC)” , Sarem Women’s Hospital, Tehran, Iran
(1) Sarem Women’s Hospital, Tehran, Iran
(2) “Sarem Fertility & Infertility Research Center (SAFIR)” and “Sarem Cell Research Center (SCRC)” , Sarem Women’s Hospital, Tehran, Iran
Correspondence
Address: Sarem Women’s Hospital, Basij Square, Phase 3, Ekbatan Town, Tehran, Iran. Postal Code: 1396956111Phone: +98 (21) 44670888
Fax: +98 (21) 44670432
saremiat@yahoo.com
Article History
Received: March 23, 2017Accepted: June 25, 2017
ePublished: August 15, 2017
ABSTRACT
Information & Methods
Spontaneous splenic transplantation and implant in in abdominal and pelvic regions is splenosis, which occurs after splenectomy followed by trauma and surgery. The clinical significance of splenic implant and the requirement for its removal are debatable. The cases of splenic implants in the pelvic zone have rarely been reported. Generally, these patients have no clinical features and are usually discovered by chance.
In this report, a 36-year-old woman with the history of splenectomy after an accident at the age of 4 was introduced with Dysmenorrhea and infertility; the primary diagnosis was endometriosis, but pathology results reported the splenosis. Whole tissues and implants of spleen around the ovary and choledosac were removed; following this, the patient’s pain was reduced and the overall health improved.
Conclusion Splenosis can emerge as a benign condition in the abdomen and pelvis, and can show itself as a spread of tissue implants in the pelvic cavity. It can, however, easily be mistaken for endometriosis in imaging.
Conclusion Splenosis can emerge as a benign condition in the abdomen and pelvis, and can show itself as a spread of tissue implants in the pelvic cavity. It can, however, easily be mistaken for endometriosis in imaging.
CITATION LINKS
[1]Waugh Rl. Multiple peritoneal autotransplantation of splenic tissue following traumatic rupture of the Spleen. N Engl J Med. 1946;234:621-5.
[2]Buchbinder JH, Lipkoff CJ. Splenosis: Multiple peritoneal splenic implants following abdominal injury. A report of a case and review of the literature. Surgery. 1939;6(6):927-34.
[3]Auerbach RD, Kohorn EI, Cornelius EA, Chambers JT. Splenosis: A complicating factor in total abdominal hysterectomy. Obstet gynecol. 1985;65(3 Suppl):65S-8S.
[4]Overton TH. Splenosis: A cause of pelvic pain. Am J Obstet Gynecol. 1982;143(8):969-70.
[5]Belhassen A, Aubineau JM, Bouverne B, Gautier P. Splenosis: An unrecognized cause of pelvic pain. J Gynecol Obstet Biol Reprod (Paris). 1987;16(3):335-8.
[6]Stovall TG, Ling FW. Splenosis: Report of a case and review of the literature. Obstet gynecol surv. 1988;43(2):69-72.
[7]Griggs JA, Rudoff J, Coddington CC. Mayer-Rokitansky-Kuster-Hauser syndrome with splenosis. A case report. J Reprod Med. 1990;35(8):821-3.
[8]Higgins RV, Crain JL. Laparoscopic removal of pelvic splenosis. A case report. J Reprod Med. 1995;40(2):140-2.
[9]Matonis LM, Luciano AA. A case of splenosis masquerading as endometriosis. Am J Obstet Gynecol. 1995;173(3 Pt 1):971-3.
[10]Kwok CM, Chen YT, Lin HT, Su CH, Liu YS, Chiu YC. Portal vein entrance of splenic erythrocytic progenitor cells and local hypoxia of liver, two events cause intrahepatic splenosis. Med Hypotheses. 2006;67(6):1330-2.
[11]Fremont RD, Rice TW. Splenosis: A review. South Med J. 2007;100(6):589-93.
[12]Skinner EF, Hurteau WW. Autotransplantation of spleen into thorax. J Thorac Surg. 1957 Jun;33(6):807-13.
[13]Kim K, Choi HJ, Kim YM, Kwon WJ, Lee WC, Suh JH. Thoracic splenosis: A case report and the importance of clinical history. J Korean Med Sci. 2010;25(2):299-303
[14]Wojcik J, Grodzki T, Kozlowska I, Urbanski S, Kubisa B. Usefulness of the scintigraphic assessment of the thoracic splenosis, a case report. Pneumonol Alergol Pol. 2008;76(6):456-9.
[15]Velitchkov NG, Kjossev KT, Losanoff JE, Kavardjikova VA. Subcutaneous splenosis: a clue to diagnosis of thoracic splenosis. J R Coll Surg Edinb. 2000;45(1):66.
[16]Yeh CJ, Chuang WY, Kuo TT. Unusual subcutaneous splenosis occurring in a gunshot wound scar: Pathology and immunohistochemical identification. Pathol Int. 2006;56(6):336-9.
[17]Rickert CH, Maasjosthusmann U, Probst-Cousin S, August C, Gullotta F. A unique case of cerebral spleen. Am J Surg Pathol. 1998;22(7):894-6.
[18]Talati H, Radhi J. Ovarian splenosis: a case report. Case Rep Med. 2010;2010:472162.
[19]Muller U, Rothlin M. Splenic neoformation following trauma-induced splenectomy diagnosis and function. Swiss Surg. 1995;(5):230-5.
[20]Pirozynski WJ, Allan CM. Abdominal splenosis. Can Med Assoc J. 1974;111(2):159.
[21]Carr NJ, Turk EP. The histological features of splenosis. Histopathology. 1992;21(6):549-53.
[22]Cotlar AM, Cerise EJ. Splenosis: The autotransplantation of splenic tissue following injury to the spleen; report of two cases and review of the literature. Annals of surgery. 1959;149(3):402-14.
[23]Basile RM, Morales JM, Zupanec R. Splenosis. A cause of massive gastrointestinal hemorrhage. Arch Surg. 1989;124(9):1087-9.
[24]Sikov WM, Schiffman FJ, Weaver M, Dyckman J, Shulman R, Torgan P. Splenosis presenting as occult gastrointestinal bleeding. Am J Hematol. 2000;65(1):56-61.
[25]Delamarre J, Capron JP, Drouard F, Joly JP, Deschepper B, Carton S. Splenosis: Ultrasound and CT findings in a case complicated by an intraperitoneal implant traumatic hematoma. Gastrointest Radiol. 1988;13(3):275-8.
[26]Depypere L, Goethals M, Janssen A, Olivier F. Traumatic rupture of splenic tissue 13 years after splenectomy. A case report. Acta chir Belg. 2009;109(4):523-6.
[27]Zitzer P, Pansky M, Maymon R, Langer R, Bukovsky I, Golan A. Pelvic splenosis mimicking endometriosis, causing low abdominal mass and pain. Hum Reprod. 1998;13(6):1683-5.
[28]Varma DG, Campeau RJ, Kartchner ZA, Karnik S. Scintigraphic detection of splenosis causing ureteral compression and hydronephrosis. AJR Am J Roentgenol. 1991;156(2):406.
[29]Mazur EM, Field WW, Cahow CE, Schiffman FJ, Duffy TP, Forget BG. Idiopathic thrombocytopenic purpura occurring in a subject previously splenectomized for traumatic splenic rupture. Role of splenosis in the pathogenesis of thrombocytopenia. Am J Med. 1978;65(5):843-6.
[30]Atkins HL, Goldman AG, Fairchild RG, Oster ZH, Som P, Richards P, et al. Splenic sequestration of 99mTc labeled, heat treated red blood cells. Radiology. 1980;136(2):501-3.
[31]Ksiadzyna D. A case report of abdominal splenosis-a practical mini-review for a gastroenterologist. J Gastrointestin Liver Dis. 2011;20(3):321-4.
[32]Cohen EA. Splenosis; Review and report of subcutaneous splenic implant. AMA Arch Surg. 1954;69(6):777-84.
[33]Watson RJ. Splenogonadal fusion. Surgery. 1968;63(5):853-8.
[34]Rosenthal JT, Bedetti CD, Labayen RF, Christy WC, Yakulis R. Right splenorenal fusion with associated hypersplenism J Urol. 1981;126(6):812-4.
[35]Meneses MF, Ostrowski ML. Female splenic-gonadal fusion of the discontinuous type. Hum Pathol. 1989;20(5):486-8.
[36]Khan AM, Manzoor K, Gordon D, Berman A. Thoracic splenosis: A diagnosis by history and imaging. Respirology. 2008;13(3):481-3.
[37]Renne G, Coci A, Biraghi T, Schmid C. Fine needle aspiration of thoracic splenosis: A case report. Acta cytol. 1999;43(3):492-4.
[38]Malik UF, Martin MR, Patel R, Mahmoud A. Parenchymal thoracic splenosis: History and nuclear imaging without invasive procedures may provide diagnosis. J Clin Med Res. 2010;2(4):180-4.
[39]Crivellaro C, Cabrini G, Gay E, Sara R, Rossetti C. Intrathoracic splenosis: Evaluation by 99mTc-labelled heat-denatured erythrocyte SPECT/CT. Eur J Nucl Med Mol Imaging. 2011;38(2):412.
[40]Lin WC, Lee RC, Chiang JH, Wei CJ, Chu LS, Liu RS, et al. MR features of abdominal splenosis. AJR Am J Roentgenol. 2003;180(2):493-6.
[41]Armas RR. Clinical studies with spleen-specific radiolabeled agents. Semin Nucl Med. 1985;15(3):260-75.
[42]Gunes I, Yilmazlar T, Sarikaya I, Akbunar T, Irgil C. Scintigraphic detection of splenosis: Superiority of tomographic selective spleen scintigraphy. Clin Radiol. 1994;49(2):115-7.
[43]Pearson HA, Johnston D, Smith KA, Touloukian RJ. The born-again spleen. Return of splenic function after splenectomy for trauma. N Engl J Med. 1978;298(25):1389-92.
[44]Barbaros U, Dinccag A, Kabul E. Minimally invasive surgery in the treatment of splenosis. Surg Laparosc Endosc Percutan Tech. 2006;16(3):187-9.
[2]Buchbinder JH, Lipkoff CJ. Splenosis: Multiple peritoneal splenic implants following abdominal injury. A report of a case and review of the literature. Surgery. 1939;6(6):927-34.
[3]Auerbach RD, Kohorn EI, Cornelius EA, Chambers JT. Splenosis: A complicating factor in total abdominal hysterectomy. Obstet gynecol. 1985;65(3 Suppl):65S-8S.
[4]Overton TH. Splenosis: A cause of pelvic pain. Am J Obstet Gynecol. 1982;143(8):969-70.
[5]Belhassen A, Aubineau JM, Bouverne B, Gautier P. Splenosis: An unrecognized cause of pelvic pain. J Gynecol Obstet Biol Reprod (Paris). 1987;16(3):335-8.
[6]Stovall TG, Ling FW. Splenosis: Report of a case and review of the literature. Obstet gynecol surv. 1988;43(2):69-72.
[7]Griggs JA, Rudoff J, Coddington CC. Mayer-Rokitansky-Kuster-Hauser syndrome with splenosis. A case report. J Reprod Med. 1990;35(8):821-3.
[8]Higgins RV, Crain JL. Laparoscopic removal of pelvic splenosis. A case report. J Reprod Med. 1995;40(2):140-2.
[9]Matonis LM, Luciano AA. A case of splenosis masquerading as endometriosis. Am J Obstet Gynecol. 1995;173(3 Pt 1):971-3.
[10]Kwok CM, Chen YT, Lin HT, Su CH, Liu YS, Chiu YC. Portal vein entrance of splenic erythrocytic progenitor cells and local hypoxia of liver, two events cause intrahepatic splenosis. Med Hypotheses. 2006;67(6):1330-2.
[11]Fremont RD, Rice TW. Splenosis: A review. South Med J. 2007;100(6):589-93.
[12]Skinner EF, Hurteau WW. Autotransplantation of spleen into thorax. J Thorac Surg. 1957 Jun;33(6):807-13.
[13]Kim K, Choi HJ, Kim YM, Kwon WJ, Lee WC, Suh JH. Thoracic splenosis: A case report and the importance of clinical history. J Korean Med Sci. 2010;25(2):299-303
[14]Wojcik J, Grodzki T, Kozlowska I, Urbanski S, Kubisa B. Usefulness of the scintigraphic assessment of the thoracic splenosis, a case report. Pneumonol Alergol Pol. 2008;76(6):456-9.
[15]Velitchkov NG, Kjossev KT, Losanoff JE, Kavardjikova VA. Subcutaneous splenosis: a clue to diagnosis of thoracic splenosis. J R Coll Surg Edinb. 2000;45(1):66.
[16]Yeh CJ, Chuang WY, Kuo TT. Unusual subcutaneous splenosis occurring in a gunshot wound scar: Pathology and immunohistochemical identification. Pathol Int. 2006;56(6):336-9.
[17]Rickert CH, Maasjosthusmann U, Probst-Cousin S, August C, Gullotta F. A unique case of cerebral spleen. Am J Surg Pathol. 1998;22(7):894-6.
[18]Talati H, Radhi J. Ovarian splenosis: a case report. Case Rep Med. 2010;2010:472162.
[19]Muller U, Rothlin M. Splenic neoformation following trauma-induced splenectomy diagnosis and function. Swiss Surg. 1995;(5):230-5.
[20]Pirozynski WJ, Allan CM. Abdominal splenosis. Can Med Assoc J. 1974;111(2):159.
[21]Carr NJ, Turk EP. The histological features of splenosis. Histopathology. 1992;21(6):549-53.
[22]Cotlar AM, Cerise EJ. Splenosis: The autotransplantation of splenic tissue following injury to the spleen; report of two cases and review of the literature. Annals of surgery. 1959;149(3):402-14.
[23]Basile RM, Morales JM, Zupanec R. Splenosis. A cause of massive gastrointestinal hemorrhage. Arch Surg. 1989;124(9):1087-9.
[24]Sikov WM, Schiffman FJ, Weaver M, Dyckman J, Shulman R, Torgan P. Splenosis presenting as occult gastrointestinal bleeding. Am J Hematol. 2000;65(1):56-61.
[25]Delamarre J, Capron JP, Drouard F, Joly JP, Deschepper B, Carton S. Splenosis: Ultrasound and CT findings in a case complicated by an intraperitoneal implant traumatic hematoma. Gastrointest Radiol. 1988;13(3):275-8.
[26]Depypere L, Goethals M, Janssen A, Olivier F. Traumatic rupture of splenic tissue 13 years after splenectomy. A case report. Acta chir Belg. 2009;109(4):523-6.
[27]Zitzer P, Pansky M, Maymon R, Langer R, Bukovsky I, Golan A. Pelvic splenosis mimicking endometriosis, causing low abdominal mass and pain. Hum Reprod. 1998;13(6):1683-5.
[28]Varma DG, Campeau RJ, Kartchner ZA, Karnik S. Scintigraphic detection of splenosis causing ureteral compression and hydronephrosis. AJR Am J Roentgenol. 1991;156(2):406.
[29]Mazur EM, Field WW, Cahow CE, Schiffman FJ, Duffy TP, Forget BG. Idiopathic thrombocytopenic purpura occurring in a subject previously splenectomized for traumatic splenic rupture. Role of splenosis in the pathogenesis of thrombocytopenia. Am J Med. 1978;65(5):843-6.
[30]Atkins HL, Goldman AG, Fairchild RG, Oster ZH, Som P, Richards P, et al. Splenic sequestration of 99mTc labeled, heat treated red blood cells. Radiology. 1980;136(2):501-3.
[31]Ksiadzyna D. A case report of abdominal splenosis-a practical mini-review for a gastroenterologist. J Gastrointestin Liver Dis. 2011;20(3):321-4.
[32]Cohen EA. Splenosis; Review and report of subcutaneous splenic implant. AMA Arch Surg. 1954;69(6):777-84.
[33]Watson RJ. Splenogonadal fusion. Surgery. 1968;63(5):853-8.
[34]Rosenthal JT, Bedetti CD, Labayen RF, Christy WC, Yakulis R. Right splenorenal fusion with associated hypersplenism J Urol. 1981;126(6):812-4.
[35]Meneses MF, Ostrowski ML. Female splenic-gonadal fusion of the discontinuous type. Hum Pathol. 1989;20(5):486-8.
[36]Khan AM, Manzoor K, Gordon D, Berman A. Thoracic splenosis: A diagnosis by history and imaging. Respirology. 2008;13(3):481-3.
[37]Renne G, Coci A, Biraghi T, Schmid C. Fine needle aspiration of thoracic splenosis: A case report. Acta cytol. 1999;43(3):492-4.
[38]Malik UF, Martin MR, Patel R, Mahmoud A. Parenchymal thoracic splenosis: History and nuclear imaging without invasive procedures may provide diagnosis. J Clin Med Res. 2010;2(4):180-4.
[39]Crivellaro C, Cabrini G, Gay E, Sara R, Rossetti C. Intrathoracic splenosis: Evaluation by 99mTc-labelled heat-denatured erythrocyte SPECT/CT. Eur J Nucl Med Mol Imaging. 2011;38(2):412.
[40]Lin WC, Lee RC, Chiang JH, Wei CJ, Chu LS, Liu RS, et al. MR features of abdominal splenosis. AJR Am J Roentgenol. 2003;180(2):493-6.
[41]Armas RR. Clinical studies with spleen-specific radiolabeled agents. Semin Nucl Med. 1985;15(3):260-75.
[42]Gunes I, Yilmazlar T, Sarikaya I, Akbunar T, Irgil C. Scintigraphic detection of splenosis: Superiority of tomographic selective spleen scintigraphy. Clin Radiol. 1994;49(2):115-7.
[43]Pearson HA, Johnston D, Smith KA, Touloukian RJ. The born-again spleen. Return of splenic function after splenectomy for trauma. N Engl J Med. 1978;298(25):1389-92.
[44]Barbaros U, Dinccag A, Kabul E. Minimally invasive surgery in the treatment of splenosis. Surg Laparosc Endosc Percutan Tech. 2006;16(3):187-9.