Identification of perirenal or renal splenosis from undetermined masses: case report and review of the literature
- Authors
- Cho, Sung Gun; Yi, Joo Hark; Kim, Min Yeong; Kim, Young Hwan; Han, Sang Woong; Kim, Ho Jung
- Issue Date
- Oct-2014
- Publisher
- DUSTRI-VERLAG DR KARL FEISTLE
- Keywords
- splenosis; renal splenosis; malignancy; nuclear scintigraphy; single photon emission computed tomography (SPECT); fusion imaging
- Citation
- CLINICAL NEPHROLOGY, v.82, no.4, pp.263 - 267
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL NEPHROLOGY
- Volume
- 82
- Number
- 4
- Start Page
- 263
- End Page
- 267
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/159049
- DOI
- 10.5414/CN107890
- ISSN
- 0301-0430
- Abstract
- The incidental finding of tumor- like perirenal or renal splenosis (PRS) creates a challenge to the renal physicians, because its benign nature has to be distinguished from a malignancy. This paper describes the case of a 40-year-old man referred from a local clinic for further evaluation of an incidental finding of left abdominal masses by ultrasonogram suspecting neoplasm, but was eventually confirmed as PRS by obtaining a history of splenectomy that pointed to splenosis and subsequently by a fusion image from single photon emission computed tomography using Tc-99m-labelled heat-denatured erythrocytes and computed tomography (hybrid SPECT/CT). In addition, a review of 27 cases of PRS in a MEDLINE search including the present case revealed the following: all the masses were found incidentally and were associated with a history of previous splenectomy or splenic injury; the initial impressions were neoplastic tumor/PRS (n = 9), PRS (n = 10), and neoplastic tumor without consideration of splenosis (n = 8); surgical exploration was undertaken in all the 8 cases of suspected neoplastic tumor only, whereas non-invasive radiological or radionuclide imaging confirmed splenosis in the rest of the cases (n = 19). To avoid unnecessary tests and invasive surgery for undetermined perirenal or renal masses accompanying previous splenic injury, we stress the paramount importance of careful history-taking, physical examination, and a high index of suspicion for splenosis. Also, fusion imaging of hybrid SPECT/CT was reconfirmed as a useful diagnostic technique for accurately detecting and localizing splenic tissues by PRS.
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