Thoracic splenosis: Precision medicine can prevent thoracic surgery

Thoracic splenosis is a rare condition referring to the auto-transplantation of splenic tissue into the thoracic cavity following splenic trauma. We present a case of thoracic splenosis in a 62-year-old man who at the age of 17 suffered three gunshot wounds to the posterior thorax and abdomen, requiring a splenectomy and intercostal catheter insertion. In 2007, he underwent a thoracotomy and biopsy of a left sided pulmonary mass which was complicated by a haemothorax requiring an emergent return to theatre and rib resection to achieve haemostasis. The biopsy revealed granulation tissue. In 2023, Technetium-99m (Tc-99m) heat-damaged erythrocyte scintigraphy confirmed the diagnosis of thoracic splenosis. This case highlights the importance of recognizing this uncommon condition to prevent unnecessary investigation, as well as the use of Tc-99m heat-damaged erythrocyte scintigraphy to confirm the diagnosis.