Diagnostic challenge of intrahepatic splenosis masquerading as hepatocellular carcinoma: A case report and review of literature

doi:10.3748/wjg.120967

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Oct 14, 2026; 32(38): 120967
Published online Oct 14, 2026. doi: 10.3748/wjg.120967

Table 1 Timeline of clinical events

Year	Clinical events
Childhood	Splenectomy
May 2024	Ischemic stroke. US: Focal liver lesion
June 2024	Contrast-enhanced abdominal MSCT: Focal lesions of unknown etiology
July 2024	MRI: Focal lesion suspicious of HCC
August 2024	Referring to the Department of Gastroenterology
September 2024	Percutaneous biopsy of non-lesional liver tissue: Healthy liver parenchyma; Normal tumor marker values
October 2024	Radiological multidisciplinary meeting: Bleeding risk from biopsy; Surgery chosen as diagnostic and therapeutic modality
November 2024	Surgical resection of the focal liver lesion. Histopathological analysis: Intrahepatic splenosis
November 2024 to April 2025	Regular follow-ups. Further evaluation if clinically indicated

HCC: Hepatocellular carcinoma; MRI: Magnetic resonance imaging; MSCT: Multislice computed tomography; US: Ultrasound.

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Table 2 Summary of epidemiological and clinical characteristics of reported cases of intrahepatic splenosis[4,9-85]

Epidemiological and clinical characteristics	Cases, n	%
Male sex¹	64	81
Age > 40 years¹	60	76
Splenectomy
Overall	77	96
Due to trauma²	65	86
Cirrhosis	7	9

¹Not disclosed by Martínez Del Valle Torres et al[24] and Hu et al[84].

²Not disclosed by Lau and Lao[81].

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Table 3 Diagnostic methods for intrahepatic splenosis according to initial differential diagnosis and presence of extrahepatic lesions[9,10,12-15,17-54,56-63,65-70,72-74,76,77,79-85]

Extrahepatic lesions	Primary differential diagnosis	Diagnosis	Count
No	HCC	Biopsy	8
		Surgery	22
		Scintigraphy	3
	Other malignancy	Biopsy	2
		Surgery	6
		Scintigraphy	1
	Benign (non-HS)	Biopsy	3
		Surgery	9
		Scintigraphy	2
	HS	Biopsy	3
	HS	Scintigraphy	2
Yes	HCC	Surgery	2
	HCC	Scintigraphy	1
	Other malignancy	Surgery	2
	Other malignancy	Scintigraphy	1
	Benign (non-HS)	Scintigraphy	2
	HS	Biopsy	1
	HS	Scintigraphy	3

HCC: Hepatocellular carcinoma; HS: Intrahepatic splenosis.

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Citation: Sikiric M, Premec H, Mijic M, Sobocan N, Filipec Kanizaj T, Lovric E, Kavur L, Lalovac M. Diagnostic challenge of intrahepatic splenosis masquerading as hepatocellular carcinoma: A case report and review of literature. World J Gastroenterol 2026; 32(38): 120967
URL: https://www.wjgnet.com/1007-9327/full/v32/i38/120967.htm
DOI: https://dx.doi.org/10.3748/wjg.120967

Sikiric M, Premec H, Mijic M, Sobocan N, Filipec Kanizaj T, Lovric E, Kavur L, Lalovac M. Diagnostic challenge of intrahepatic splenosis masquerading as hepatocellular carcinoma: A case report and review of literature. World J Gastroenterol 2026; 32(38): 120967 [DOI: 10.3748/wjg.120967]

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