To highlight the atypical clinical features and diagnostic considerations of giant chronic splenic infarction, which can mimic splenic neoplasm in a patient with rheumatic heart disease.
Approach:
Case Presentation: A 73-year-old female with a history of rheumatic heart disease presented with recurrent epigastric pain for 2 years. Imaging suggested a splenic neoplasm, leading to splenectomy, which confirmed extensive splenic infarction. The patient had an uneventful postoperative recovery and was discharged on postoperative day 10.
Key Findings:
The patient had a large splenic mass with imaging features suggestive of a neoplasm.
Pathological examination revealed extensive splenic infarction with focal fibrosis and calcification.
Rheumatic heart disease may have contributed to splenic infarction as a cardioembolic source.
Interpretation:
Giant chronic splenic infarction can be misdiagnosed due to atypical clinical manifestations and imaging features that resemble tumors.
Limitations:
The exact etiology of the splenic infarction could not be definitively established.
No direct evidence of intracardiac thrombus or embolic material was identified.
The potential role of rheumatic heart disease as a contributing factor remains speculative.
Conclusion:
A comprehensive assessment of clinical history, laboratory results, imaging findings, and cardiac status is crucial to reduce misdiagnosis.
