Splenosis Presenting as Pancreatic Neoplasm: Report of Two Cases

Plenosis is the auto transplantation of splenic tissue generally seen after traumatic injury or elective splenectomy. Although this condition affects one to two thirds of patients submitted to splenectomy for trauma, Splenosis is rarely diagnosed preoperatively, and sometimes, it is mistaken for a neoplasm. We report two consecutive patients, incidentally discovered to have a mass in the tail of the pancreas, during a work-up for other pathology. Both patients had undergone splenectomy, 12 and 14 years before, respectively. Abdominal ultra sonography, computed tomography, and magnetic resonance imaging demonstrated a round, solid mass with low contrast enhancement in the pancreatic tail: both clinical and radiologic findings suggested for the first patient, a solid-cystic or neuroendocrine tumour of the pancreas. After distal pancreatectomy, microscopic examination revealed heterotrophic splenic tissue. The second patient presented with two solid, round masses in the tail, and in the peripancreatic tissue of the head of the pancreas, respectively. Tc-99 sulphur colloid scintigraphic showed intense tracer uptake in both lesions, suggesting the presence of splenic tissue. So, surgical operation was avoided. Splenosis should be considered in the differential diagnosis of incidental pancreatic masses in previously splenectomised patients.