Congenital intrathoracic accessory spleen is a very rare trick of nature: a case report
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(2020) 15:232
CASE REPORT
Open Access
Congenital intrathoracic accessory spleen is a very rare trick of nature: a case report Mohammed O. Suraju1* , Nicole Peyton2, Brian Mooers1, Chris Jensen2 and Joel Shilyansky1
Abstract Background: Congenital intrathoracic accessory spleen (CIAS) refers to a developmental anomaly resulting in the presence of splenic tissue within the chest. The differential diagnoses for the resulting mass are pulmonary malformations, or lesions with malignant potential. To our knowledge, only four cases of presumed CIAS have been described in literature to date, and no cases were reported in the United States. Case presentation: We report on a 14-year-old Caucasian female with a left chest mass discovered incidentally on a CT scan performed following an all-terrain vehicle accident. Following resection, the mass was diagnosed as a CIAS. Conclusions: From our review of literature, we found that CIAS can pose a diagnostic dilemma as it is rare, difficult to distinguish from pulmonary sequestration, or malignancy, and biopsy is often inconclusive. Resection is required to rule out malignancy and determine the diagnosis. Pediatric thoracic surgeons should consider CIAS in their differential for an intrathoracic mass with an inconclusive biopsy. Keywords: Congenital intrathoracic accessory spleen, Thoracic splenule, Splenosis, Bronchopulmonary sequestration
Background The presence of splenic tissue in the thoracic cavity can be acquired or congenital. Acquired intrathoracic spleen (splenosis) commonly occurs following splenic and/or diaphragmatic injury that results in the seeding of splenic tissue in the chest [1]. In contrast, congenital intrathoracic accessory spleen (CIAS) is the presence of splenic tissue within the thoracic cavity from birth. CIAS is extremely rare, and only four reports exist in the literature. To our knowledge, no cases have been reported from the United States to date [2, 3].
* Correspondence: [email protected] 1 Department of Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., Iowa City, Iowa 52242, USA Full list of author information is available at the end of the article
In clinical practice, CIAS may pose a diagnostic dilemma [3]. Furthermore, in cases of hematologic disorders such as idiopathic thrombocytopenic purpura (ITP), a missed splenic tissue such as CIAS may result in relapse [3]. As such, we sought to highlight an interesting case of CIAS, and raise awareness about crucial aspects of its presentation based on a review of the literature.
Case presentation The patient was a 14-year-old healthy female referred to us after an intrathoracic mass was incidentally discovered in the left hemithorax on a CT scan (Fig. 1) obtained in the setting of a roll-over all-terrain vehicle (ATV) accident. She had no history of previous injuries or hospitalizations. She denied any previous history of symptoms that could be related to the
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 Internation
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