Masquerading Spleen: A Perplexing Case of Intrahepatic Splenosis Mimicking Hepatocellular Carcinoma

Intrahepatic splenosis is an uncommon condition that can present a significant diagnostic challenge, often masquerading as more sinister hepatic lesions. We report a perplexing case of a 56-year-old female with a history of splenectomy who presented with liver masses initially suspected to be hepatocellular carcinoma (HCC). Despite advanced imaging techniques, including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), the lesions convincingly mimicked HCC. Surgical resection was performed, and histopathological examination revealed the true nature of the masses: intrahepatic splenosis. This case underscores the importance of considering this rare entity in the differential diagnosis of liver masses, particularly in patients with a history of splenic trauma or splenectomy. We present a review of the literature to provide context and discuss the diagnostic conundrum posed by intrahepatic splenosis.