Pelvic splenosis mimicking ovarian metastasis of breast carcinoma: a case report

Splenosis is the heterotopic autotransplantation of splenic tissue that usually follows traumatic splenic rupture and splenectomy. Implanted splenic tissue may give rise to a mass or masses in the chest, abdomen, or pelvis which the clinician must distinguish from benign or malignant tumors. A 38-year-old multiparous woman presented for a routine gynecological examination during breast cancer treatment. She had undergone splenectomy following traumatic splenic rupture at the age of 13. Pelvic examination revealed a left adnexal mass. Transvaginal ultrasonography showed a 39x56x40 mm diameter hyperechoic, hypervascular solid tumor on the left ovary. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. The postoperative histological diagnosis was splenic tissue. Splenosis must be considered in the differential diagnosis of previosly splenectomized patients who present with unexplained masses.