title: Large pelvic accessory spleen mimicking an adnexal malignancy in a teenage girl.
abstract: A large pelvic accessory spleen in a teenage female is rare and may be misdiagnosed as an adnexal tumor. A 17-year-old girl, gravida 0, had suffered from intermittent and dull pain in the lower abdomen for 1 month. Laboratory evaluation showed a low platelet count (136,000/microL). Abdominal sonography showed a large solid mass situated at the right pelvis, containing abundant vascular supply with low resistant blood flow. At laparotomy, an accessory spleen fed by a tortuous vascular pedicle from the omentum was found and then excised. Histopathologic examination revealed congestive accessory splenomegaly. Follow-up platelet count returned to normal levels (374,000/microL). The importance of including accessory spleen in the differential diagnosis of a solid adnexal tumor with thrombocytopenia is emphasized.
authors.affiliation: Departments of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: S M
authors.initials: SM
authors.lastname: Hsiao
authors.forename: L C
authors.initials: LC
authors.lastname: Lee
authors.forename: M H
authors.initials: MH
authors.lastname: Chang
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis*; D000293:Adolescent; D003937:Diagnosis, Differential; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis*; D006801:Humans; D013154:Spleen / Q000002:abnormalities*