CASE 295: SPLEEN TUMOR, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman  63 yo, pain at  left subcostal  for one  month without  fever.

Abdomen ultrasound detected  the  spleen changing its surface, irregular lobular border with  many hypoechoic  structures  intraspleen  from hilus and free fluid  around the spleen ( see us 1, us 2).

MSCT with CE found out   inhomogeneous structure of spleen, with  many  hypodense zones, non enhancement  with contrast  from  hilus of  spleen  radiated toward peripheric zones of  spleen,  and  tail of  pancreas was adherent to spleen hilus.

Radiologist  suggested tumor  of  the tail  of pancreas invasive to hilus of spleen ( see  ct 1, 2, 3).

Blood tests were normal all cancer markers, and blood amylase highly elevated.

Preoperative  diagnosis  the case  was  vascular thrombosis of  spleen due to  inflammation of the pancreatic tail.

Operation  for  splenectomy, and  removing the hilus mass of spleen ( see macro).

Microscopic report  was chronic necrosis due to inflammation.

Discussion: Clinical  with pain for more one month  at left upper adominal  area which was  KEHR' s sign.

Ultrasound detected  many avascular zones  in spleen.

MSCT with CE  find out  wedge – shape.

Blood test : high  amylase, looked like  PANCREATITIS  at the tail  complicated to hilus  of SPLEEN  INFARCTION.

REF  case report  from  JOP.