CASE 482 : SPLENOSIS, Dr PHAN THANH HẢI- Dr TRẦN CÔNG DUY LONG, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Man 38yo with  abdominal pain  like gastritis. Clinical detected arterial hypertension.

In past history he had been in an urgent operation of rupture of spleen by trauma for 10 years ( photo).

Ultrasound  detected  one  mass at border of right liver near upper pole of right kidney  and  sonologist suspected an adrenal gland tumor  ( US 1, US 2 CDI , US 3  view with linear probe).

MSCT of  abdomen=   CT 1:crossed section of  tumor  at border of liver, 

CT 2 with CE  is  low enhanced  tissue.

After being treated in stable blood pressure, a laparotomy removed  big tumor at liver border in retroperitoneum  and  some intra abdomen small nodules.

Microscopic report is normal tissue of spleen.

It is  splenosis  due to rupture of the spleen 10 years before.   

DISCUSSION:
For this case  ULTRASOUND, CT, MRI  CANNOT  DIAGNOSE  SPLENOSIS.

With BLOOD TEST of WAKO NEGATIF  and HISTORY  of SPLENECTOMY, SUGGESTION pre-op IS SPLENOSIS.( MRI  WITH GADO  ALSO CANNOT  DIAGNOSE THIS CASE).

REFERENCE:

1-Thoracic splenosis  dr Nguyen quy Khoang

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