Renal Pseudo-tumor Related to Renal Splenosis: Imaging Features.

Mickael Tordjman, David Eiss, Jonathan Dbjay, Adeline Crosnier, Eva Comperat, Jean-Michel Correas, Nicolas De Saint Aubert, Olivier Helenon

Journal: Urology 2018;114():e11-e15

PMID: 29378278

Abstract

OBJECTIVE

To report the case of a 29-year-old patient presenting with renal splenosis along with a complete review of literature on this condition. Splenosis is a frequent condition following abdominal trauma or splenectomy, described as splenic tissue that autotransplants into a heterotopic location. However, renal splenosis is rare and often mistaken with renal carcinoma.

MATERIALS AND METHODS

The patient was initially referred to our department for a renal mass incidentally discovered on ultrasound. Further investigation included with computed tomography and magnetic resonance imaging.

RESULTS

Imaging features revealed a well circumscribed solid renal mass, exhibiting an isosignal on T1- and T2-weighted sequences in comparison with the renal cortex. The mass exhibited a heterogeneous enhancement on the arterial and portal phases, homogeneous patterns during the delayed phases, and high signal intensity on diffusion-weighted images. A partial nephrectomy was performed and pathological examination revealed the final diagnosis of renal splenosis.

CONCLUSION

Imaging features alone do not provide a definitive diagnosis of splenosis but suggestive past history associated with imaging findings consistent with splenic tissue should lead to technetium-sulfur colloid scanning or ferumoxid-enhanced MRI to avoid useless surgery.

Copyright © 2018 Elsevier Inc. All rights reserved.

Address: Department of Adult Radiology, Necker Hospital, Paris, France. Electronic address: [email protected].; Department of Adult Radiology, Necker Hospital, Paris, France.; Department of Adult Radiology, Necker Hospital, Paris, France; Paris Descartes Medical School, Paris Descartes University, Paris, France.; Pathology Department, Tenon Hospital, APHP, Paris, France.; Department of Urology, Hôpital Européen Georges Pompidou, APHP, Paris, France.
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