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Thoracic splenosis: Precision medicine can prevent thoracic surgery.

Respirol Case Rep

November 2024

Respiratory and Sleep Medicine South Western Sydney Local Health District Sydney New South Wales Australia.

Thoracic splenosis is a rare condition referring to the auto-transplantation of splenic tissue into the thoracic cavity following splenic trauma. We present a case of thoracic splenosis in a 62-year-old man who at the age of 17 suffered three gunshot wounds to the posterior thorax and abdomen, requiring a splenectomy and intercostal catheter insertion. In 2007, he underwent a thoracotomy and biopsy of a left sided pulmonary mass which was complicated by a haemothorax requiring an emergent return to theatre and rib resection to achieve haemostasis.

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Article Synopsis
  • The spleen develops from mesenchymal cells in the dorsal mesentery during embryogenesis, and accessory spleens are common anomalies that can be mistaken for tumors; this case is the first report of three accessory spleens found in Syria in a patient who had a prior splenectomy.
  • A 33-year-old male experienced right-sided abdominal pain, and after medical evaluation, imaging tests showed a lobulated mass in the right adrenal gland and elevated levels of metanephrine, suggesting a pheochromocytoma; laparoscopic surgery ultimately revealed multiple accessory spleens without signs of cancer.
  • The case emphasizes the importance of considering accessory spleens in patients with masses near the adrenal glands, as they can complicate diagnosis and treatment
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Intrahepatic splenosis is an uncommon condition that can present a significant diagnostic challenge, often masquerading as more sinister hepatic lesions. We report a perplexing case of a 56-year-old female with a history of splenectomy who presented with liver masses initially suspected to be hepatocellular carcinoma (HCC). Despite advanced imaging techniques, including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), the lesions convincingly mimicked HCC.

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Article Synopsis
  • This case series examines the challenges of diagnosing and managing non-cancerous ovarian masses through three specific examples: struma ovarii, mature teratoma, and an ovarian mass with peritoneal splenosis.
  • The first case shows how a struma ovarii was wrongly suspected to be cancerous because of its complex imaging, leading to confusion in diagnosis.
  • The series emphasizes the need for a thorough diagnostic strategy that uses imaging, surgical observations, and tissue analysis to accurately differentiate between benign and malignant conditions in ovarian health.*
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Background: 18F-prostate specific membrane antigen (PSMA) PET is fast becoming the gold-standard in prostate cancer, both in staging of intermediate-/high-risk patients and in re-staging patients with biochemical failure. Several pitfalls of 18F-PSMA PET have been reported, and we report, to our best of knowledge, for the first time, a case which could have been falsely diagnosed as peritoneal spread.

Case Presentation: A 67-year-old patient with high-risk prostate cancer underwent staging with 18F-PSMA-1007 PET/CT (PSMA-PET/CT).

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