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Retroperitoneal accessory spleen simulating a suprarenal mass

1969; Wiley; Volume: 42; Issue: 504 Linguagem: Inglês

10.1259/0007-1285-42-504-939

1748-880X

Wolf Rosenkranz, Bernard Kamhi, Marcel I. Horowitz,

Amoebic Infections and Treatments

Accessory spleens are common and have been reported in one-fifth to one-third of all autopsies. They are most often found in the young. These organs may be single or multiple, 1 mm to 4 cm in size, and are histologically and functionally identical to a normal spleen. They represent splenic anlagen which failed to fuse with the lienal aggregates during embryonic development. Therefore, they are normally supplied by branches of the splenic artery. They are most frequently located in the gastrosplenic ligament, near the hilus of the spleen, and in the retroperitoneal region around the tail of the pancreas. They are sometimes situated in the omentum, in the mesenteries of the small and large intestines, and even in the left gonads. After a splenectomy, accessory spleens occasionally undergo compensatory enlargement. Eccles and Freer (1921) reported a case of post-splenectomy enlargement of an accessory spleen to the size of a normal spleen ten years after operation. Das Gupta and Busch (1960) reported a case of an accessory spleen on the tail of the pancreas which produced a gastric indentation resembling a neoplasm. Autotransplantation of splenic tissue (splenosis) may occur after splenectomy for traumatic rupture of the spleen. In such cases, numerous transplanted nodules, consisting of splenic pulp, are found seeded throughout the peritoneum and omentum. A 37-year-old white male was in good health until two weeks prior to admission, when, after a bout of influenza, he experienced headaches and dizziness.