Pelvic Splenosis Diagnosed 23 Years after Splenectomy: Report of a Case

一位26歲男性，在他小時候因為車禍導致脾臟破裂，並接受脾臟切除手術。病人因為兩側腰痛來醫院求診，下腹部超音波顯示兩側腎臟結石以外，意外地發現在骨盆腔下方右側儲精囊與直腸之間有一腫瘤。腹部電腦斷層顯示，此腫瘤大小為3.5公分，肛門指診顯示直腸黏膜平滑，但在直腸前面可摸到此腫瘤。病人三個月後再次接受腹部電腦斷層檢查，發現此腫瘤略微增大為4公分，而決定開刀切除。病理報告發現，此腫瘤為一副脾。這種骨盆腔脾臟組織植入，在臨床上非常罕見，其原因有二：一為先天性脾臟組織植入；二為脾臟受傷或是接受脾臟切除手術後所殘留下來的脾臟組織發展而成。我們在此提出此該病例，並做相關文獻探討。

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並列摘要

A 26-year-old male had a history of traffic accident in his childhood, and he underwent splenectomy due to traumatic splenic rupture. The patient suffered from bilateral flank pain for one month. Lower abdominal sonography showed bilateral caliceal stones and a well-defined hypervascular solitary mass in the lower pelvis near the right seminal vesicle incidentally. Abdominal computed tomography (CT) scan revealed a solid mass about 3.5 cm in size between the rectum and seminal vesicle. The follow-up abdominal CT scan three months later revealed that the mass became larger, about 4 cm in size. He underwent laparotomy and a well- circumscribed soft tissue between the right seminal vesicle and rectum was found and excised. The pathology was accessory spleen. Accessory spleen is present in approximately 10-30% of the general population, and is mostly located near the splenic hilum, the tail of the pancreas, or greater omentum. Pelvic accessory spleen is rare. We review the literature regarding accessory spleen and splenosis. The most possible origin in this case is splenosis, autotransplantation of splenic tissue during splenectomy or following trauma.

並列關鍵字

accessory spleen ； splenosis

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Pelvic Splenosis Diagnosed 23 Years after Splenectomy: Report of a Case

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