Splenunculus mimicking as a metastatic lymph node: day to day case with a teaching point

Posted By SanthoshKumar GV
Splenunculus mimicking as a metastatic lymph node: day to day case with a teaching point

In the evaluation of carcinoma esophagus, positron emission tomography-computed tomography/Computed tomography is done for baseline staging of Carcinoma esophagus. In local regionally advanced cases neoadjuvant chemotherapy is given followed by a response assessment positron emission tomography/computed tomography. We report a case of carcinoma esophagus, showing response in the primary lesion on follow-up scan, however, there was an increase in the metastatic nodal mass in the gastrosplenic ligament. On review of the scan, it was found to be a splenunculus in an atypical location along the lesser curvature of stomach, with feeding artery from the splenic artery and attenuation same as that of the spleen. Retrospective review of the positron emission tomography showed it to be non-radiotracer avid, proving it to be splenunculus. Though it is a common entity, it is imperative to identify and report normal variants, as it can impact case management significantly in such cases.

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