title: Ectopic Spleen Tissue - an Underestimated Differential Diagnosis of a Hypervascularised Liver Tumour.
abstract: BACKGROUND
  Patients with liver cirrhosis have an increased risk of developing hepatocellular carcinoma (HCC). Implantation metastasis following diagnostic biopsy is a well-known complication. Therefore, primary resection of a hypervascularised tumour suspicious for HCC is often performed with curative intent.
  
  
  METHODS
  An exophytically growing mass was diagnosed between liver segments III and IVb by means of ultrasound in a 53-year old male patient with decompensated liver cirrhosis. Computed tomography confirmed a 3.5 cm large hypervascularised tumour with given resectability. Intraoperatively, the tumour appeared like a HCC. Thus, an atypical resection was performed. Histopathology revealed ectopic spleen tissue without any signs of malignancy. As enquiries revealed, the patient had undergone splenectomy after a blunt abdominal trauma 9 years prior to admission.
  
  
  CONCLUSIONS
  In the present patient, hepatic splenosis in a cirrhotic liver was misinterpreted as HCC. In patients with a history of traumatic rupture of the spleen or splenectomy, splenosis has to be considered as a potential differential diagnosis of a hypervascularised tumour. Specific diagnostics should be performed to rule out splenosis.
authors.affiliation: Department of General, Thoracic, Vascular and Transplantation Surgery, University of Rostock, Rostock, Germany.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Grambow
authors.affiliation: Department of General, Thoracic, Vascular and Transplantation Surgery, University of Rostock, Rostock, Germany.
authors.forename: Malte
authors.initials: M
authors.lastname: Weinrich
authors.affiliation: Institute of Pathology, University of Rostock, Rostock, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Zimpfer
authors.affiliation: Institute of Diagnostic and Interventional Radiology, University of Rostock, Rostock, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Kloker
authors.affiliation: Department of General, Thoracic, Vascular and Transplantation Surgery, University of Rostock, Rostock, Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Klar
keywords: Hypervascularised tumour; Liver resection; Liver tumour; Splenosis