title: Identification of perirenal or renal splenosis from undetermined masses: case report and review of the literature.
abstract: The incidental finding of tumor-llke perirenal or renal splenosis (PRS) creates a challenge to the renal physicians, because its benign nature has to be distinguished from a malignancy. This paper describes the case of a 40-year-old man referred from a local clinic for further evaluation of an incidental finding of left abdominal masses by ultrasonogram suspecting neoplasm, but was eventually confirmed as PRS by obtaining a history of splenectomy that pointed to splenosis and subsequently by a fusion image from single photon emission computed tomography using 99mTc-labelled heat-denatured erythrocytes and computed tomography (hybrid SPECT/CT). In addition, a review of 27 cases of PRS in a MEDLINE search including the present case revealed the following: all the masses were found incidentally and were associated with a history of previous splenectomy or splenic injury; the initial impressions were neoplastic tumor/PRS (n = 9), PRS (n = 10), and neoplastic tumor without consideration of splenosis (n = 8); surgical exploration was undertaken in all the 8 cases of suspected neoplastic tumor only, whereas non-invasive radiological or radionuclide imaging confirmed splenosis in the rest of the cases (n = 19). To avoid unnecessary tests and invasive surgery for undetermined perirenal or renal masses accompanying previous splenic injury, we stress the paramount importance of careful history-taking, physical examination, and a high index of suspicion for splenosis. Also, fusion imaging of hybrid SPECT/CT was reconfirmed as a useful diagnostic technique for accurately detecting and localizing splenic tissues by PRS.
authors: Sung Gun
authors: SG
authors: Cho
authors: Joo Hark
authors: JH
authors: Yi
authors: Min Yeong
authors: MY
authors: Kim
authors: Young Hwan
authors: YH
authors: Kim
authors: Sang Woong
authors: SW
authors: Han
authors: Ho Jung
authors: HJ
authors: Kim
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D033162:Incidental Findings; D007668:Kidney / Q000000981:diagnostic imaging*; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D064847:Multimodal Imaging / Q000379:methods; D013156:Splenectomy / Q000009:adverse effects; D017890:Splenosis / Q000175:diagnosis*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D018615:Ultrasonography, Doppler, Color / Q000379:methods