Abstract
BackgroundEctopic spleen is extremely rare. Most cases are congenital, acquired ectopic spleen may be a consequence of surgery or trauma to the spleen. The ectopic spleen in the gastric wall we reported is even rarer.Case presentationWe report a 41-year-old female patient, with a past history of splenectomy, who presented with heartburn. Gastroscopy revealed a swelling in the fundus in the stomach. Ultrasonography and computed tomographic examination suggested the possibility of gastrointestinal stromal tumor. We performed endoscopic resection of the mass. Pathological examination of the resected mass showed ectopic spleen.ConclusionWhen a patient with a history of splenectomy presents with a gastric submucosal tumor, ectopic spleen should also be considered in the differential diagnoses. And minimally invasive endoscopic treatment can achieve the purpose of diagnosis and treatment for unobvious submucosal tumors.
Highlights
When a patient with a history of splenectomy presents with a gastric submucosal tumor, ectopic spleen should be considered in the differential diagnoses
Case presentation A 41-year-old woman with a history of splenectomy 8 years previously for aplastic anemia was admitted to the 900th Hospital of People’s liberation army (PLA), Fuzhou, China, with complaints of repeated attacks of heartburn over the last 6 months
(See figure on previous page.) Fig. 1 a On esophagogastroduodenoscopy a spherical bulge was seen in the fundus of the stomach; the overlying mucosa was smooth. b Endoscopic ultrasound showed an oval slightly hypoechoic area protruding into the fundus of the stomach without calcification; the mass originated from the fourth layer. c Abdominal Computed tomography (CT) scan suggested the possibility of gastrointestinal stromal tumor. d The mucosal was incised with Dual-Knife. e IT-Knife nano was used to remove the tumor. f The tumor was well exposed. g After the tumor was completely dissected, the defect in the muscularis was closed by an over-the-scope clip (OTSC). h The OTSC closed the wound well. i
Summary
When a patient with a history of splenectomy presents with a gastric submucosal tumor, ectopic spleen should be considered in the differential diagnoses.
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