Answer: Posttraumatic splenosis
Pathologic examination of the specimen revealed a splenosis showing regular red and white pulp (Figure E). Splenosis is the heterotopic autotransplantation of splenic tissue within the abdominal or pelvic cavity and occurs in 16%–67% of patients with a history of splenic trauma or splenic surgery.1 Nevertheless, hepatic splenosis is rare.2 The literature documents only 16 case reports of hepatic splenosis, although the difficulty of diagnosis could have contributed to underreporting. Although usually harmless, splenosis is a rare cause of bowel obstruction or abdominal pain.
1. Fleming, C.R., Dickson, E.R., Harrison, E.G. Splenosis: autotransplantation of splenic tissue. Am J Med. 1976;61:414-9.
2. D’Angelica, M., Fong, Y., Blumgart, L.H. Isolated hepatic splenosis: first reported case. HPB Surg. 1998;11:39-42.
3. Ohmoto, K., Mimura, N., Iguchi, Y. et al. Percutaneous microwave coagulation therapy for superficial hepatocellular carcinoma on the surface of the liver. Hepatogastroenterology. 2003;50:1547-51.