Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5724
Peer-review started: March 9, 2021
First decision: April 4, 2021
Revised: April 16, 2021
Accepted: May 24, 2021
Article in press: May 24, 2021
Published online: July 16, 2021
Processing time: 119 Days and 17.7 Hours
Splenosis is a rare benign disease that often disguises itself as a malignant tumor. There are few articles providing a comprehensive description of splenosis, especially cases located in the stomach being treated by laparoscopic surgery.
A 44-year-old man presented with recurrent upper abdominal pain for more than half a year. The patient had splenic rupture caused by trauma more than 10 years ago and underwent splenectomy. An abdominal contrast-enhanced computed tomography scan revealed an irregular soft tissue density. Gastroscopy revealed an approximately 3.0 cm × 3.0 cm mucosal eminence at the posterior wall of the upper segment of the gastric body. Biopsy was not performed since the lesion was found under the mucosa and the gastric mucosa appeared normal. According to these findings, a diagnosis of gastric stromal tumor was made, although a definitive differential diagnosis was not known before surgery. When laparoscopic resection of the gastric stromal tumor was performed, an astonishing finding was made when postoperative pathology showed that the lesion comprised typical spleen tissue.
This case highlights the strong similarities between splenosis and malignant tumors. A detailed medical history combined with various effective auxiliary examinations can help improve differential diagnosis.
Core Tip: Here we report a patient whose preoperative examinations revealed a gastric stromal tumor located in the body of the stomach. Nonetheless, the postoperative pathology showed that the tumor consisted of splenic tissue. The patient’s prior splenectomy was a predisposing factor, indicating that patient history together with other auxiliary examinations should be used to assist diagnosis. We summarize the diagnostic references and surgical indications of splenosis, providing an important tool for clinical practice.