Pararenal splenosis encountered during the evaluation of a suspected pheochromocytoma.
The authors describe a patient in whom pararenal splenosis nodules were initially interpreted as probable pheochromocytoma. A 22-year-old man with chronic glomerulonephritis, hypertension and a childhood history of splenectomy was hospitalized for a hypertensive emergency. He did not improve with aggressive antihypertensive therapy. A pheochromocytoma was suspected, and a renal ultrasound and a magnetic resonance imaging showed 2 left pararenal masses. Laboratory evaluation for pheochromocytoma and aldosteronoma were negative. Biopsies of the masses were planned, but the masses were subsequently shown to be splenic tissue by a (99m)technnetium heat-damaged red blood cell scan. Ectopic splenic masses, eg, splenosis or accessory spleens, should be considered in patients with undiagnosed abdominal or kidney masses and a history of splenectomy.
Brown
Joel D
JD
Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96813, USA. jbrown@queens.org
Kwee
Sandi
S
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D010673:Pheochromocytoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D011877:Radionuclide Imaging; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology*; D013156:Splenectomy / Q000009:adverse effects; D017890:Splenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult