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Miguez González J, Calaf Forn F, Pelegrí Martínez L, Lozano Arranz P, Oliveira Caiafa R, Català Forteza J, Palacio Arteaga LM, Losa Gaspà F, Ramos Bernadó I, Barrios Sánchez P, Ayuso Colella JR. Primary and secondary tumors of the peritoneum: key imaging features and differential diagnosis with surgical and pathological correlation. Insights Imaging 2023; 14:115. [PMID: 37395913 DOI: 10.1186/s13244-023-01417-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/30/2023] [Indexed: 07/04/2023] Open
Abstract
Peritoneal malignancies represent a diagnostic challenge for abdominal radiologists, oncologists, surgeons and pathologists in multidisciplinary teams, who must address their differential diagnosis, staging and treatment. In this article, we explain the pathophysiology of these processes and lay out the role of different imaging techniques in their evaluation. Then, we review the clinical and epidemiological aspects, the main radiological features and the therapeutic approaches for each primary and secondary peritoneal neoplasm, with surgical and pathological correlation. We further describe other rare peritoneal tumors of uncertain origin and a variety of entities that may mimic peritoneal malignancy. Finally, we summarize the key imaging findings of each peritoneal neoplasm to facilitate an accurate differential diagnosis that may impact patient management.Clinical relevance statementImaging plays an essential role in the evaluation of peritoneal malignancies, assessing their extension, detecting unfavorable sites of involvement and facilitating an accurate differential diagnosis, helping to choose the best therapeutic approach.
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Affiliation(s)
- Javier Miguez González
- Department of Radiology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain.
| | - Francesc Calaf Forn
- Department of Radiology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | - Laura Pelegrí Martínez
- Department of Radiology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | - Pilar Lozano Arranz
- Department of Radiology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | - Rafael Oliveira Caiafa
- Department of Radiology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | - Jordi Català Forteza
- Department of Radiology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | - Lina Maria Palacio Arteaga
- Department of Pathology, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | - Ferrán Losa Gaspà
- Department of Medical Oncology, Institut Català d'Oncologia Hospitalet, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Barcelona, Spain
| | - Isabel Ramos Bernadó
- Peritoneal Surface Malignancies Unit, Department of Surgery, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
| | - Pedro Barrios Sánchez
- Former Director of the Peritoneal Carcinomatosis Program of Catalonia, Former Head of the Peritoneal Surface Malignancies Unit, Department of Surgery, Complex Hospitalari Universitari Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain
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Choi MG, Woo W, Chang JY, Kim BJ, Kim Y, Moon DH, Lee S. Combined Intrathoracic and Abdominal Splenosis. Am J Case Rep 2022; 23:e937902. [PMID: 36435962 PMCID: PMC9713598 DOI: 10.12659/ajcr.937902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Splenosis refers to autotransplantation of splenic tissue after splenic injury or splenectomy, most frequently occurring in the abdominal and pelvic cavities. Thoracic splenosis is a rare condition associated with a history of simultaneous rupture of the spleen and diaphragm resulting from trauma. To the best of our knowledge, only a limited number of cases have been reported for combined intrathoracic and abdominal splenosis. CASE REPORT We present a case of a 50-year-old man with a history of splenectomy and left nephrectomy 15 years ago due to an accident, who had experienced chest pain for the past month. A 1-cm focal pleural thickening in the left posterior pleura was revealed on the chest computed tomography (CT) scan. We found this to be suspicious for a solitary fibrous tumor. Based on this information, surgery was performed for tumor removal, and the pathologic examination confirmed splenic tissues. The patient was then discharged without any complications. Further abdominopelvic CT showed several contrast-enhanced lesions, suggestive of intraperitoneal splenosis. CONCLUSIONS We would like to emphasize the importance of thorough history-taking to avoid misdiagnosis and unnecessary procedures with respect to the rarity of splenosis. Moreover, appropriate use of diagnostic tools, including radionuclide imaging studies, is recommended to establish an accurate diagnosis of thoracic splenosis.
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Intussusception due to intramural jejunal splenosis. Pediatr Radiol 2021; 51:144-147. [PMID: 32666263 DOI: 10.1007/s00247-020-04731-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/21/2020] [Accepted: 05/20/2020] [Indexed: 10/23/2022]
Abstract
Splenosis is defined as the growth of ectopic splenic tissue, due to its direct seeding, usually seen after traumatic or surgical procedures to the spleen. It often occurs on highly vascularized surfaces such as the omentum or the mesentery, and grows in sessile form, supplied by adjacent vessels. Intestinal splenosis with endoluminal extension is extremely rare. We present a case of intestinal splenosis with endoluminal growth in a 14-year-old boy that provoked a small bowel intussusception requiring surgical resolution.
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Splenosis: A Rare Etiology for Bowel Obstruction-A Case Report and Review of the Literature. Case Rep Surg 2015; 2015:890602. [PMID: 26543660 PMCID: PMC4620401 DOI: 10.1155/2015/890602] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 09/27/2015] [Indexed: 01/31/2023] Open
Abstract
Splenosis is a historically uncommon etiology for bowel obstruction. Autotransplanted splenic tissues following surgery or trauma of the spleen are known to occur in multiple locations of the abdominal cavity and pelvis. The small bowel mesentery is a blood vessel-rich environment for growth of splenic fragments. We present a case of a 36-year-old male patient who sustained a gunshot wound to his left abdomen requiring a splenectomy and bowel resection fifteen years prior to his presentation with small bowel obstruction requiring exploration, adhesiolysis, and resection of the mesenteric splenic deposit. Our aim in this report is to provide awareness of splenosis as an etiology for bowel obstruction, especially with increased incidence and survival following abdominal traumas requiring splenectomies. We also stress on the importance of history and physical examination to include splenosis on the list of differential diagnoses for bowel obstruction.
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Baraket O, Ayed K, Moussa M, Ben Moussa M, Kort B, Bouchoucha S. Splénose péritonéale révélée par une masse sous-hépatique. Presse Med 2014; 43:869-71. [DOI: 10.1016/j.lpm.2013.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 11/06/2013] [Accepted: 11/18/2013] [Indexed: 10/25/2022] Open
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Abstract
Invasive peritoneal disease includes more than just peritoneal carcinomatosis. Although this is the most common aetiology, especially when a primary is found, other conditions may be responsible for peritoneal invasion. A rigorous analysis of CT features taken together with the clinical and biological context usually allows the main differential diagnoses, which entail different types of management, to be drawn out. Pseudomyxoma peritonei, peritoneal lymphomatosis, tuberculosis, peritoneal mesothelioma, diffuse peritoneal leiomyomatosis, and benign splenosis are the main differential diagnoses.
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