Tubal splenosis: unusual location of the spleen

Introduction: Splenosis is defined as the autotransplantation of splenic tissue to abnormal locations after splenic injury. Heterotopic spleen can be found within the abdominal and pelvic cavities. We report a tubal splenosis case in a 48 year old woman who underwent splenectomy following a blunt trauma 41 years prior to presentation. Case report: A 48 years old gravida 3, para 3, was admitted to our gynecology clinic for pelvic pain, menstrual irregularities and abnormal bleeding. The patient had a six months history of sonographically detected 40 x 20 mm pelvic mass. She also had a blunt trauma and splenectomy history from 41 years ago. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Intraoperative exploration revealed a 40 mm sized suspicious mass immediately adjacent to the right fallopian tube. The histopathologic examination of the specimen reported normal splenic tissue with polymorphous small lymphocytes, granulocytes, and frequent hemosiderin laden macrophages. Discussion: Posttraumatic pelvic splenosis is a rare condition. Splenosis should be kept in mind as a differential diagnosis especially for patients with a history of posttraumatic splenectomy who are scheduled for pelvic mass surgery. Although most of the patients are diagnosed postoperatively, if preoperative diagnosis could be made, there is no medical indication for this normally functioning tissue to be resected.