Unveiling three accessory spleens in one patient: a rare case report and literature review

Abstract Background During embryogenesis, the spleen undergoes intricate developmental processes, originating from mesenchymal cells in the dorsal mesentery. An accessory spleen, a common anomaly found in autopsies and abdominal CT scans, can often be mistaken for different types of tumors. To the b...

Full description

Saved in:
Bibliographic Details
Main Authors: Hamdah Hanifa, Hussein Alhussein, Lissa Mahmandar, Sara Kadi, Mahfoud Najjar, Ahmad Alhaj
Format: Article
Language:English
Published: BMC 2024-11-01
Series:International Journal of Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12245-024-00758-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846148077443874816
author Hamdah Hanifa
Hussein Alhussein
Lissa Mahmandar
Sara Kadi
Mahfoud Najjar
Ahmad Alhaj
author_facet Hamdah Hanifa
Hussein Alhussein
Lissa Mahmandar
Sara Kadi
Mahfoud Najjar
Ahmad Alhaj
author_sort Hamdah Hanifa
collection DOAJ
description Abstract Background During embryogenesis, the spleen undergoes intricate developmental processes, originating from mesenchymal cells in the dorsal mesentery. An accessory spleen, a common anomaly found in autopsies and abdominal CT scans, can often be mistaken for different types of tumors. To the best of our knowledge, this is the first case in Syria documenting the occurrence of 3 accessory spleens in a patient who had previously undergone splenectomy. Case presentation A 33-year-old male presented with right hypochondrium pain, sharp and radiating to the right flank, exacerbated by movement and large meals. Past medical history included mild Irritable Bowel Syndrome (IBS) and splenectomy due to a traumatic accident in childhood. On admission, vital signs were stable, with abdominal tenderness in the right upper quadrant. Laboratory investigations showed normal values. Ultrasound revealed a lobulated mass at the right adrenal gland (4.5 × 5 cm) with an isoechoic to hypoechoic texture. Multi-slice computed tomography (MSCT) Scan showed multiple nodules in the right adrenal gland, regular in shape, exerting a compressive mass effect, and significant lymphadenopathy around the abdominal aorta. Elevated metanephrine levels raised suspicion of an extra-adrenal pheochromocytoma. Laparoscopic surgery was performed, revealing accessory spleens and normal adrenal tissue with no malignancy. Conclusion Healthcare providers should consider accessory spleens as a differential diagnosis for masses near the adrenal glands. Multiple accessory spleens in the adrenal region can complicate cases. Accessory spleens in uncommon locations like the adrenal glands can be challenging to diagnose and manage.
format Article
id doaj-art-015aeacd0a5e4396a80c6cfdb4324f55
institution Kabale University
issn 1865-1380
language English
publishDate 2024-11-01
publisher BMC
record_format Article
series International Journal of Emergency Medicine
spelling doaj-art-015aeacd0a5e4396a80c6cfdb4324f552024-12-01T12:08:24ZengBMCInternational Journal of Emergency Medicine1865-13802024-11-011711610.1186/s12245-024-00758-3Unveiling three accessory spleens in one patient: a rare case report and literature reviewHamdah Hanifa0Hussein Alhussein1Lissa Mahmandar2Sara Kadi3Mahfoud Najjar4Ahmad Alhaj5Faculty of Medicine, University of KalamoonFaculty of Medicine, University of AleppoFaculty of Medicine, University of AleppoFaculty of Medicine, University of AleppoDepartment of Surgery, General Surgery Division, Aleppo University HospitalDepartment of Surgery, Faculty of Medicine, University of AleppoAbstract Background During embryogenesis, the spleen undergoes intricate developmental processes, originating from mesenchymal cells in the dorsal mesentery. An accessory spleen, a common anomaly found in autopsies and abdominal CT scans, can often be mistaken for different types of tumors. To the best of our knowledge, this is the first case in Syria documenting the occurrence of 3 accessory spleens in a patient who had previously undergone splenectomy. Case presentation A 33-year-old male presented with right hypochondrium pain, sharp and radiating to the right flank, exacerbated by movement and large meals. Past medical history included mild Irritable Bowel Syndrome (IBS) and splenectomy due to a traumatic accident in childhood. On admission, vital signs were stable, with abdominal tenderness in the right upper quadrant. Laboratory investigations showed normal values. Ultrasound revealed a lobulated mass at the right adrenal gland (4.5 × 5 cm) with an isoechoic to hypoechoic texture. Multi-slice computed tomography (MSCT) Scan showed multiple nodules in the right adrenal gland, regular in shape, exerting a compressive mass effect, and significant lymphadenopathy around the abdominal aorta. Elevated metanephrine levels raised suspicion of an extra-adrenal pheochromocytoma. Laparoscopic surgery was performed, revealing accessory spleens and normal adrenal tissue with no malignancy. Conclusion Healthcare providers should consider accessory spleens as a differential diagnosis for masses near the adrenal glands. Multiple accessory spleens in the adrenal region can complicate cases. Accessory spleens in uncommon locations like the adrenal glands can be challenging to diagnose and manage.https://doi.org/10.1186/s12245-024-00758-3Accessory spleenCase reportMisdiagnosisSplenosisPheochromocytomaAdrenal tumour
spellingShingle Hamdah Hanifa
Hussein Alhussein
Lissa Mahmandar
Sara Kadi
Mahfoud Najjar
Ahmad Alhaj
Unveiling three accessory spleens in one patient: a rare case report and literature review
International Journal of Emergency Medicine
Accessory spleen
Case report
Misdiagnosis
Splenosis
Pheochromocytoma
Adrenal tumour
title Unveiling three accessory spleens in one patient: a rare case report and literature review
title_full Unveiling three accessory spleens in one patient: a rare case report and literature review
title_fullStr Unveiling three accessory spleens in one patient: a rare case report and literature review
title_full_unstemmed Unveiling three accessory spleens in one patient: a rare case report and literature review
title_short Unveiling three accessory spleens in one patient: a rare case report and literature review
title_sort unveiling three accessory spleens in one patient a rare case report and literature review
topic Accessory spleen
Case report
Misdiagnosis
Splenosis
Pheochromocytoma
Adrenal tumour
url https://doi.org/10.1186/s12245-024-00758-3
work_keys_str_mv AT hamdahhanifa unveilingthreeaccessoryspleensinonepatientararecasereportandliteraturereview
AT husseinalhussein unveilingthreeaccessoryspleensinonepatientararecasereportandliteraturereview
AT lissamahmandar unveilingthreeaccessoryspleensinonepatientararecasereportandliteraturereview
AT sarakadi unveilingthreeaccessoryspleensinonepatientararecasereportandliteraturereview
AT mahfoudnajjar unveilingthreeaccessoryspleensinonepatientararecasereportandliteraturereview
AT ahmadalhaj unveilingthreeaccessoryspleensinonepatientararecasereportandliteraturereview