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Unexpected diagnosis at laparotomy: intrahepatic splenosis mimicking hepatocellular carcinoma - a case report
Taha Anıl Kodalak1, Ramazan Kubilay Tekcan2, Arif Burak Çekiç2
1Department of General Surgery, Kanuni Training and Research Hospital, Trabzon, Turkey.
Introduction:
Intrahepatic splenosis (IS) is a rare benign condition developing after splenic tissue autotransplantation, usually post-trauma or splenectomy. In HBV-infected patients, it can mimic hepatocellular carcinoma (HCC), leading to misdiagnosis and unnecessary surgery.
Presentation Of Case:
A 42-year-old man with chronic HBV infection and prior splenectomy had a 4-cm hepatic lesion with arterial enhancement and venous washout, consistent with HCC. Laparotomy revealed a dark-purple mass and diaphragmatic nodules; frozen and histopathology confirmed splenic tissue. The patient recovered well and remained recurrence-free after 1 year.
Discussion:
IS should be considered in patients with previous splenectomy and hepatic masses to avoid misdiagnosis. Noninvasive imaging such as Tc-99m-labeled RBC scintigraphy can prevent unnecessary resections.
Conclusion:
Increasing awareness of IS may help prevent unnecessary liver resections in similar cases.
