Robotically assisted removal of pelvic splenosis fifty-six years after splenectomy: A case report

'Splenosis' is defined as the autotransplantation of splenic tissue following trauma or surgery, usually in the form of intraperitoneal nodules. The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules, and achieving a differential diagn...

Full description

Saved in:
Bibliographic Details
Published inWorld journal of clinical cases Vol. 9; no. 12; pp. 2868 - 2873
Main Authors Tognarelli, Alessio, Faggioni, Lorenzo, Erba, Anna Paola, Faviana, Pinuccia, Durante, Jacopo, Manassero, Francesca, Selli, Cesare
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 26.04.2021
Subjects
Case Report
Nuclear medicine
Pelvic splenosis
Case report
Computed tomography
Da Vinci Xi
Robotically assisted laparoscopy
Online AccessGet full text

Cover

More Information
Summary:'Splenosis' is defined as the autotransplantation of splenic tissue following trauma or surgery, usually in the form of intraperitoneal nodules. The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules, and achieving a differential diagnosis can be challenging. Nuclear medicine studies have been playing an increasingly important role in this process, but the clinical significance of asymptomatic nodules remains uncertain. We present a case of pelvic splenosis in a 73-year-old man diagnosed 56 years after a splenectomy during a computed tomography (CT) follow-up for B-cell lymphoma, presenting intense contrast enhancement of an 18 mm nodule in the right recto-vesical space. 18F-fluorodeoxyglucose demonstrated weak metabolic activity. Since histological diagnosis was deemed necessary, the nodule was easily removed with robotically assisted laparoscopy, together with another 6 mm left a paracolic lesion. The latter was previously undiagnosed but retrospectively visible on the CT scan. In a patient requiring differential diagnosis of splenosis nodules from lymphoma recurrence, the robotic approach provided a safe removal with short hospitalization. The Da Vinci Xi robot was particularly helpful because its optics can be introduced from all ports, facilitating visualization and lysis of multiple intra-abdominal adhesions.
Bibliography:Corresponding author: Alessio Tognarelli, MD, Resident, Department of Translational Research and New Technologies in Medicine and Surgery, Section of Urology, University of Pisa, Via Savi 10, Pisa 56126, Italy. alessio.tognarelli@gmail.com
Author contributions: Tognarelli A contributed to data acquisition, reviewed the literature and drafted the manuscript; Faggioni L and Erba AP analysed and interpreted images and contributed to figure elaboration; Faviana P performed the histological diagnosis and contributed to the multidisciplinary evaluation; Manassero F contributed to the diagnosis and multidisciplinary evaluation; Durante J contributed to patient’s treatment and data acquisition; Selli C contributed to patient’s treatment, reviewed the literature and drafted the manuscript; all authors issued final approval for the version to be submitted.
ISSN:2307-8960
2307-8960
DOI:10.12998/wjcc.v9.i12.2868