Wandering spleen presenting as a pediatric pelvic mass

Wandering spleen is a rare entity, especially in the pediatric age group. It is a result of congenital incomplete fusion of the dorsal mesogastrium and may be further aggravated by abdominal organomegaly or by visceroptosis, as in prune belly syndrome. Its discovery may be incidental to variable abdominal complaints such as intermittent pain, vomiting, and anorexia, or as an acute abdomen in the event of torsion of its vascular pedicle. In a clinical setting where malignancy is suspected, it is desirable to resolve quickly whether the abdominal or pelvic mass represents tumor or tumor-related splenomegaly. Multiple imaging modalities may contribute to the solution to this problem; however, Tc-99m SC radionuclide imaging is the most specific method, providing splenic vascular perfusion is not compromised.