• Shao-Yan Xu, Ke Sun, Hai-Yang Xie, Lin Zhou, Shu-Sen Zheng, and Weilin Wang.
• Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province Department of Pathology, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China.
• Medicine (Baltimore). 2017 Sep 1; 96 (38): e7957e7957.

RationaleAccessory spleen is a congenital abnormality caused by failure of the splenic anlage to fuse during embryology. The presence of an accessory spleen located in the parietal peritoneum has not been reported so far, and an accessory spleen situated on the right side is extremely rare. In the present study, we describe the first case of an accessory spleen located in the right parietal peritoneum.Patients ConcernsA 65-year-old man, presented with pain in his left abdomen for 1 month.DiagnosesWith ultrasonography and computed tomography, it was difficult to determine the accurate location and diagnosis, and an abdominal fibroma was preoperatively considered.InterventionsBy laparotomy, we found a mass connected to the right parietal peritoneum by a vascular pedicle. We resected it completely, and the gross specimen measured 5.0 × 3.0 × 2.5 cm and was a localized tumor with a capsule.OutcomesMicroscopically, sinusoids were visible, as well as scattered lymphoid follicles, eosinophils, histiocytes, plasma cells, neutrophils, and red blood cells, indicative of splenic tissue. Finally, the lesion was diagnosed as an accessory spleen located in the right parietal peritoneum. Postoperatively, he recovered well and was followed up for a 31 months, during which he was well with no complication.LessonsWe present the first accessory spleen located in the right parietal peritoneum. Awareness of the accessory spleen and familiarity with typical imaging findings are necessary for surgeons to make a precise preoperative diagnosis.

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