Renal Pseudo-tumor Related to Renal Splenosis: Imaging Features

Urology. 2018 Apr:114:e11-e15. doi: 10.1016/j.urology.2018.01.017. Epub 2018 Jan 31.

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 99m technetium-sulfur colloid scanning or ferumoxid-enhanced MRI to avoid useless surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Granuloma, Plasma Cell / diagnostic imaging*
  • Granuloma, Plasma Cell / surgery
  • Humans
  • Kidney Neoplasms / diagnostic imaging*
  • Kidney Neoplasms / surgery
  • Magnetic Resonance Imaging / methods*
  • Male
  • Nephrectomy / methods
  • Rare Diseases
  • Risk Assessment
  • Splenosis / diagnostic imaging*
  • Splenosis / surgery
  • Tomography, X-Ray Computed / methods*