Frontiers in cardiovascular medicine · 2026
Giant chronic splenic infarction mimicking splenic neoplasm in a patient with rheumatic heart disease: a case report.
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Tian Wei, Deng Xu, Yang Chunyuan, Tian Jianxing, Zhu Zonglong, Huang Rui, Pan Wei
Аннотация
BACKGROUND: Giant chronic splenic infarction is an extremely rare condition with insidious onset and atypical imaging features, carrying a high risk of misdiagnosis as splenic neoplasm. This case highlights the atypical clinical features and important diagnostic considerations of this uncommon disorder.
CASE DESCRIPTION: A 73-year-old female presented with recurrent epigastric pain for 2 years, with a medical history of rheumatic heart disease and hypertension. Contrast-enhanced abdominal computed tomography showed a huge splenic mass measuring approximately 18.0 × 14.2 × 19.1 cm with heterogeneous enhancement and calcification, which was highly suggestive of splenic neoplasm. The patient received splenectomy, and pathological examination confirmed extensive splenic infarction with focal fibrosis and calcification. The patient had an uneventful postoperative recovery, with no evidence of thrombosis or infectious complications during the 3-month follow-up period.
CONCLUSION: Rheumatic heart disease with mitral stenosis may have contributed to splenic infarction as a possible cardioembolic source in this patient. Giant chronic splenic infarction may be misdiagnosed because of atypical clinical manifestations, tumor-mimicking imaging features, and insufficient integration of clinical, laboratory, and imaging findings. A comprehensive assessment of clinical history, laboratory results, imaging findings, and cardiac status may help reduce misdiagnosis and guide appropriate management.
CASE DESCRIPTION: A 73-year-old female presented with recurrent epigastric pain for 2 years, with a medical history of rheumatic heart disease and hypertension. Contrast-enhanced abdominal computed tomography showed a huge splenic mass measuring approximately 18.0 × 14.2 × 19.1 cm with heterogeneous enhancement and calcification, which was highly suggestive of splenic neoplasm. The patient received splenectomy, and pathological examination confirmed extensive splenic infarction with focal fibrosis and calcification. The patient had an uneventful postoperative recovery, with no evidence of thrombosis or infectious complications during the 3-month follow-up period.
CONCLUSION: Rheumatic heart disease with mitral stenosis may have contributed to splenic infarction as a possible cardioembolic source in this patient. Giant chronic splenic infarction may be misdiagnosed because of atypical clinical manifestations, tumor-mimicking imaging features, and insufficient integration of clinical, laboratory, and imaging findings. A comprehensive assessment of clinical history, laboratory results, imaging findings, and cardiac status may help reduce misdiagnosis and guide appropriate management.