Rare Case of Accessory Spleen Sarcoidosis Found During Cancer Surgery

Researchers in China reported a rare case of sarcoidosis in the accessory spleen detected during diagnostic surgery for a woman in her forties. The report confirms that although rare, the possibility of such disease manifestations exists.

The study, “Isolated sarcoidosis of accessory spleen in the greater omentum: A case report,” published in the journal Experimental and Therapeutic Medicine, urges physicians to perform comprehensive surgical examinations so that disease in the accessory spleen can be excluded.

Sarcoidosis most often affects organs in the chest. Although additional organs can be affected, only about 10 percent of patients get the disease in an organ without the chest also infected.

Isolated disease of the spleen has been described in cases, but until now no reports had emerged describing sarcoidosis in the accessory spleen – a small bit of splenic tissue separate from the spleen which can form in different locations in the abdomen.

Researchers believe that accessory spleens form during embryonic development in about 10 percent of people.

The case study at Lishui Central Hospital began when the woman arrived complaining of pain in the lower part of her breastbone for two years. A gastric endoscopy eventually revealed a signet‑ring cell carcinoma tumor.

Further examination using computed tomography (CT) of the abdomen confirmed the presence of the tumor, but did not reveal other abnormalities. Physicians excluded the possibility of symptoms due to infection.

Upon examination by surgery, the the signet‑ring cell carcinoma was re-confirmed, but doctors also identified a kidney cancer. Examining all organs, the surgical team noted a lesion later deemed the accessory spleen, in a fold of the greater omentum which is the lining around the gut cavity.

Noting the presence of granulomas and gatherings of immune cells, and considering a second analysis confirming the tissue was not infected by bacteria or fungi, sarcoidosis of the accessory spleen was diagnosed.

The woman appeared completely recovered two years after removal of the tumors and the accessory spleen.