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Identification of perirenal or renal splenosis from undetermined masses: case report and review of the literature

Title
Identification of perirenal or renal splenosis from undetermined masses: case report and review of the literature
Author
한상웅
Keywords
Adult; Diagnosis; Differential; Humans; Incidental Findings; Kidney; ultrasonography; Kidney Neoplasms; diagnosis, Male; Multimodal Imaging; methods; Splenectomy; adverse effects; Splenosis; Tomography; Emission-Computed; Single-Photon; Tomography; X-Ray Computed; Ultrasonography; Doppler; Color
Issue Date
2014-10
Publisher
Dustri-Verlag Dr. Karl Feistle
Citation
Clinical nephrology, 2014, 82(4), P.263-267
Abstract
The incidental finding of tumor-llke perirenal or renal splenosis (PRS) creates a challenge to the renal physicians, because its benign nature has to be distinguished from a malignancy. This paper describes the case of a 40-year-old man referred from a local clinic for further evaluation of an incidental finding of left abdominal masses by ultrasonogram suspecting neoplasm, but was eventually confirmed as PRS by obtaining a history of splenectomy that pointed to splenosis and subsequently by a fusion image from single photon emission computed tomography using 99mTclabelled heat-denatured erythrocytes and computed tomography (hybrid SPECT/CT). In addition, a review of 27 cases of PRS in a MEDLINE search including the present case revealed the following: all the masses were found incidentally and were associated with a history of previous splenectomy or splenic injury; the initial impressions were neoplastic tumor/PRS (n = 9), PRS (n = 10), and neoplastic tumor without consideration of splenosis (n = 8); surgical exploration was undertaken in all the 8 cases of suspected neoplastic tumor only, whereas non-invasive radiological or radionuclide imaging confirmed splenosis in the rest of the cases (n = 19). To avoid unnecessary tests and invasive surgery for undetermined perirenal or renal masses accompanying previous splenic injury, we stress the paramount importance of careful history-taking, physical examination, and a high index of suspicion for splenosis. Also, fusion imaging of hybrid SPECT/CT was reconfirmed as a useful diagnostic technique for accurately detecting and localizing splenic tissues by PRS.
URI
https://www.dustri.com/article_response_page.html?artId=10477&doi=10.5414/CN107890&L=0
ISSN
0301-0430
DOI
10.5414/CN107890
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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