Renal Pseudo-tumor Related to Renal Splenosis: Imaging Features

• Published in: Urology (Ridgewood, N.J.) Vol. 114; pp. e11 - e15
• Main Authors: Tordjman, Mickael, Eiss, David, Dbjay, Jonathan, Crosnier, Adeline, Comperat, Eva, Correas, Jean-Michel, De Saint Aubert, Nicolas, Helenon, Olivier
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2018
• Subjects: Adult; Diagnosis, Differential; Granuloma, Plasma Cell - diagnostic imaging; Granuloma, Plasma Cell - surgery; Humans; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - surgery; Magnetic Resonance Imaging - methods; Male; Nephrectomy - methods; Rare Diseases; Risk Assessment; Splenosis - diagnostic imaging; Splenosis - surgery; Tomography, X-Ray Computed - methods
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2018.01.017

To report the case of a 29-year-old patient presenting with renal splenosis along with a complete review of literature on this condition. Splenosis is a frequent condition following abdominal trauma or splenectomy, described as splenic tissue that autotransplants into a heterotopic location. However, renal splenosis is rare and often mistaken with renal carcinoma. The patient was initially referred to our department for a renal mass incidentally discovered on ultrasound. Further investigation included with computed tomography and magnetic resonance imaging. Imaging features revealed a well circumscribed solid renal mass, exhibiting an isosignal on T1- and T2-weighted sequences in comparison with the renal cortex. The mass exhibited a heterogeneous enhancement on the arterial and portal phases, homogeneous patterns during the delayed phases, and high signal intensity on diffusion-weighted images. A partial nephrectomy was performed and pathological examination revealed the final diagnosis of renal splenosis. Imaging features alone do not provide a definitive diagnosis of splenosis but suggestive past history associated with imaging findings consistent with splenic tissue should lead to 99m technetium-sulfur colloid scanning or ferumoxid-enhanced MRI to avoid useless surgery.