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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 42-year-old woman with a history of breast cancer was admitted to our radiology department for progressive abdominal pain&#46; In 2013&#44; the patient underwent a left mastectomy due to infiltrating ductal breast carcinoma &#40;T1N0M0&#41;&#44; followed by adjuvant radiation therapy&#46; At 5 years of follow-up&#44; the patient showed no signs of tumor recurrence&#46; The patient also had a history of splenic laceration due to a blunt abdominal trauma 6 years earlier&#46; Palpation revealed sensitivity in the upper left abdomen&#46; Her vital signs &#40;blood pressure&#44; heart rate&#44; respiratory rate and temperature&#41; were normal&#46; The laboratory analysis&#44; hemogram&#44; hepatic function&#44; serum electrolytes and coagulation tests were also normal&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was undergoing annual follow-ups due to suspected breast cancer metastasis&#46; To determine the etiology of the abdominal pain&#44; the patient underwent abdominal magnetic resonance imaging &#40;MRI&#41; with contrast along with a diffusion-weighted MRI&#46; The MRI sequences revealed a small deformed spleen &#40;S&#44; spleen&#41; in the upper left quadrant &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; In the MRI&#44; we identified multiple solid peritoneal lesions &#40;asterisks&#41;&#44; the largest of which was 4<span class="elsevierStyleHsp" style=""></span>cm &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; These lesions had characteristic signs similar to those of the spleen in the T1&#8211;T2-weighted sequences&#46; In the dynamic contrast-enhanced T1 sequence&#44; in the arterial phase&#44; the lesions and spleen showed a heterogeneous arciform appearance&#44; with a zebra stripe pattern&#46; In the venous phase&#44; all lesions showed an improved homogeneous pattern &#40;asterisks&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C and D&#41;&#46; In the diffusion sequences&#44; all peritoneal lesions showed a restricted diffusion pattern &#40;asterisks&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>E and F&#41;&#46; In the annual MRI examinations over the course of the 5 years of follow-up&#44; there were no changes in the lesions&#46; On the fifth year of follow-up&#44; there were no significant changes either in the size or nature of the peritoneal lesions&#46; Therefore&#44; we did not believe that this was a metastatic process&#46; Based on the lesions&#8217; clinical and radiological characteristics&#44; the lesions were diagnosed as peritoneal splenosis&#46; From the radiological standpoint&#44; splenosis can resemble a morbid process&#44; including a primary neoplasia or a metastasis&#46; In the event the patient undergoes splenectomy or experiences splenic trauma&#44; we should consider splenosis instead of metastasis to avoid unnecessary surgeries and provide appropriate treatment&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>"
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Medicine in Images
DOI: 10.1016/j.rceng.2019.02.015
Multiple peritoneal splenosis mimicking mesenteric metastases in a woman with breast carcinoma
Esplenosis peritoneal múltiple simulando una metástasis mesentérica en una mujer con carcinoma mamario
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Y. Gediklia, F. Guvenb, G. Ongena, H. Ogulb,
Corresponding author
drhogul@gmail.com

Corresponding author.
a División de Radiología, Bayburt State Hospital, Bayburt, Turkey
b Departamento de Radiología, Facultad de Medicina, Universidad de Ataturk, Erzurum, Turkey

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