Inflammatory pseudotumor of the spleen managed laparoscopically. Can preoperative imaging establish the diagnosis? Case report and literature review.

BACKGROUND: Inflammatory pseudotumor of the spleen, or inflammatory myofibroblastic tumor, is an uncommon condition easily mistaken for a malignant process. Patients may be asymptomatic or may present with nonspecific abdominal complaints. Mild constitutional symptoms have also been reported. The ability to diagnose this entity radiographically preoperatively may allow the uniform application of laparoscopy to manage this condition and spare patients open splenectomy.
METHODS: Chart review and literature review.
RESULTS: Inflammatory pseudotumor of the spleen was successfully managed laparoscopically. Preoperative evaluation suggested but could not confirm the diagnosis.
CONCLUSIONS: A hypovascular solid splenic mass by Doppler ultrasound or CT scan suggests the diagnosis of inflammatory pseudotumor. Stellate central calcifications seen on CT scan make the diagnosis very likely. Laparoscopic splenectomy can be used for definitive diagnosis and symptomatic relief with minimal morbidity and mortality.