Unveiling three accessory spleens in one patient: a rare case report and literature review
Dublin Core
Title
Unveiling three accessory spleens in one patient: a rare case report and literature review
Subject
Accessory spleen, Case report, Misdiagnosis, Splenosis, Pheochromocytoma, Adrenal tumour
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 under-
gone 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 lobu-
lated 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 compres-
sive 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.
Keywords Accessory spleen, Case report, Misdiagnosis, Splenosis, Pheochromocytoma, Adrenal tumour
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 under-
gone 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 lobu-
lated 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 compres-
sive 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.
Keywords Accessory spleen, Case report, Misdiagnosis, Splenosis, Pheochromocytoma, Adrenal tumour
Creator
Hamdah Hanifa1 , Hussein Alhussein2* , Lissa Mahmandar2 , Sara Kadi2 , Mahfoud Najjar3 and
Ahmad Alhaj4
Ahmad Alhaj4
Source
https://doi.org/10.1186/s12245-024-00758-3
Date
2024
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Hamdah Hanifa1 , Hussein Alhussein2* , Lissa Mahmandar2 , Sara Kadi2 , Mahfoud Najjar3 and
Ahmad Alhaj4, “Unveiling three accessory spleens in one patient: a rare case report and literature review,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12529.