Abdominopelvic Splenosis Resembling an Ovarian Malignancy: A Case Report

Splenosis is a benign condition that most commonly occurs following traumatic splenic rupture or splenectomy. It is characterized by ectopic autotransplantation of splenic tissue, typically within the abdominal or pelvic cavities. Due to its nonspecific clinical and imaging features, splenosis is often mistaken for malignant or metastatic disease, making accurate diagnosis a persistent clinical challenge.

The diagnosis was established using multimodal imaging techniques, including transvaginal and abdominal ultrasonography with color Doppler flow imaging (CDFI), contrast-enhanced computed tomography (CECT) of the abdomen, and evaluation of serum tumor markers.

We report a case of a 31-year-old woman who underwent follow-up after an abortion and intrauterine device (IUD) placement. Transvaginal ultrasound revealed a hypoechoic, vascularized mass in the right adnexal region, which was attached to but poorly demarcated from the right ovary and adjacent bowel. Abdominal ultrasound failed to identify a spleen with typical features. Subsequent contrast-enhanced abdominal computed tomography (CECT) demonstrated multiple well-defined nodules with homogeneous soft tissue density throughout the right adnexal region, abdomen, and pelvis. Detailed medical history revealed prior traumatic splenic rupture with surgical repair. Based on these findings, a diagnosis of splenosis was established. As the patient remained asymptomatic, conservative management was adopted.

This case highlights the importance of considering splenosis in the differential diagnosis of adnexal or abdominopelvic masses, particularly in patients with a history of splenic trauma or surgery. Accurate diagnosis depends on comprehensive imaging evaluation and thorough medical history review, which are critical to preventing misdiagnosis as malignancy and avoiding unnecessary surgical intervention.