Introduction:

Splenosis in the subcutaneous tissue of the abdominal wall is extremely rare, with only 16 cases reported in the international literature, most of them secondary to splenectomy due to trauma. Only one case has been linked to splenectomy indicated for immune thrombocytopenic purpura (ITP).

Objective:

to report a clinical case of splenosis in subcutaneous tissue in a patient who underwent splenectomy for ITP.

Clinical case:

25-year-old man. Underwent splenectomy at the age of six due to immune thrombocytopenic purpura. Presented with a slow-growing mass at the external commissure of a left hypochondrium transverse incision, evolving over one year. On examination: well-defined, firm mass, 2 cm in diameter, mobile, not attached to the skin or muscle plane, and non-tender. Soft tissue ultrasound suggested parietal splenosis based on the surgical history. Diagnosis was confirmed by abdominal computed tomography. A scheduled surgical procedure was performed, with complete resection of the lesion, including a lozenge of skin and subcutaneous tissue to prevent rupture. Histopathology confirmed parietal splenosis.

Discussion:

splenosis is the heterotopic autotransplantation of splenic cells following splenic rupture due to trauma or splenectomy performed for hematological diseases, among others. There is limited literature on parietal splenosis, with the most frequent implantation site being the exit wound of a gunshot injury, followed by surgical wounds. The functionality of the implant remains a matter of debate, with between 25 and 30 cc of splenic tissue required for functional activity, far greater than the approximately 8 cc observed in our case. Furthermore, the implant can potentially lead to recurrence of the hematologic disease that initially prompted splenectomy, although this was not the case for our patient.

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