Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2021; 9(20): 5724-5729
Published online Jul 16, 2021. doi: 10.12998/wjcc.v9.i20.5724
Splenosis masquerading as gastric stromal tumor: A case report
Hui-Da Zheng, Jian-Hua Xu, Ya-Feng Sun
Hui-Da Zheng, Jian-Hua Xu, Ya-Feng Sun, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
Author contributions: Zheng HD and Xu JH contributed to conceptualization; Zheng HD wrote the original draft; Zheng HD, Sun YF, and Xu JH reviewed and edited the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hua Xu, MD, Chief Doctor, Dean, Professor, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, No. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian Province, China. xjh630913@126.com
Received: March 9, 2021
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Splenosis, Gastric stromal tumor, Laparoscopy, Case report

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.