BMJ Case Reports 2018; doi:10.1136/bcr-2017-223410
  • Unexpected outcome (positive or negative) including adverse drug reactions

Unusual case of iron overload with cancer-mimicking abdominal splenosis

  1. Domenico Girelli1
  1. 1Department of Medicine, Unit of Internal Medicine, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy
  2. 2Department of Radiology, Azienda Ospedaliera Carlo Poma, Mantova, Italy
  3. 3Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy
  1. Correspondence to Dr Giacomo Marchi, marchigiacomo{at}
  • Accepted 21 March 2018
  • Published 16 May 2018


A 48-year-old man, former alcohol abuser and drug addicted, was referred to our tertiary referral centre for iron disorders because of marked hyperferritinaemia. His clinical history revealed chronic hepatitis C, ß-thalassaemia trait and post-traumatic splenectomy at age of 22. MRI-estimated liver iron content was markedly elevated, while first-line genetic test for haemochromatosis was negative. Alpha-fetoprotein was increased but liver ultrasonography did not reveal focal liver lesions. Multiphasic contrast-enhanced CT confirmed this result but showed two abdominal masses (diameter of 9 cm and 7 cm, respectively) among bowel loops, strongly suspicious for cancer. However, biopsy of one of the masses led to the final diagnosis of abdominal splenosis.


  • Contributors GM collected the clinical data and wrote the manuscript. GA collected the radiological data and cowrote the manuscript. AZ provided histological images and cowrote the manuscript. DG supervised the clinical management of the patient and critically revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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