Splenosis: An Uncommon Cause of Right "Adrenal Incidentaloma." Case Report and Review of the Literature

ABSTRACT Objective: To present an interesting case of splenosis mimicking a right adrenal incidentaloma. Methods: We discuss the clinical presentation, diagnostic evaluation, and management of this case and review the literature for reports of right-sided retroperitoneal splenosis mimicking an adrenal mass. Results: A 4-cm right suprarenal mass was incidentally discovered during the work-up of abdominal pain in a 38-year-old female smoker with a history of hypertension and prior splenectomy following abdominal trauma 32 years earlier. Adrenal function tests were compatible with a nonsecreting adrenal incidentaloma. Imaging characteristics of the mass were not diagnostic. Diagnostic laparoscopy revealed ectopic splenic tissue, independent of the normal-appearing adrenal gland. Three cases of right-sided retroperitoneal splenosis mimicking an adrenal mass were identified in the literature and summarized. Conclusion: Splenosis should be included in the differential diagnosis of any patient with a history of posttraumatic splenectomy presenting with an adrenal incidentaloma. Abbreviations: CT computed tomography HU Hounsfield units MRI magnetic resonance imaging NRR normal reference range PET positron emission tomography