Incidental Splenic Lesions in a Complex Surgical Patient: A Diagnosis and Management Dilemma

Introduction: Incidental splenic lesions discovered during unrelated imaging often require additional radiological workup for defining differential diagnosis. This conventional framework may be inadequate for suspicious splenic capsule lesions encountered during unrelated surgery, which pose a diagnostic and management challenge.

Case presentation: A 41-year-old female was found to have papular capsular splenic lesions during robotic bilateral salpingo-oophorectomy that was not addressed during the procedure. The patient subsequently underwent a robotic partial splenectomy due to concern for malignancy. Histopathology report revealed benign splenic parenchyma with capsular adhesions.

Discussion: Capsular splenic lesions are rare findings during abdominal surgeries and thus may pose diagnostic and management dilemma. In such cases, laparoscopic or robotic-assisted partial splenectomy can provide a safe and effective diagnostic tool while preserving splenic function.

Conclusion: This case highlights the importance of including splenic adhesions in the differential for atypical splenic lesions.