More Than a Kissing Spleen: Hepatolienal Fusion as a Rare Anatomical Variant

Introduction

Anatomical variants resulting from aberrant embryological development are rare but clinically relevant findings. Among these, hepatolienal fusion is an exceptionally uncommon condition characterized by a direct parenchymal bridge between the liver and spleen. The first case was reported in 1978 [1]. To date, only a few cases have been described in the literature, mostly identified incidentally during autopsy or cross-sectional imaging. The presumed pathogenesis involves a failure of separation between the liver and spleen during early embryogenesis. Other rare variants involving splenic fusion include splenopancreatic, splenorenal, splenogonadal, and splenoadrenal fusions [2]. These are generally asymptomatic and often discovered incidentally. Awareness of such anatomical variants is important, particularly when interpreting unclear abdominal masses, and may influence surgical or interventional planning.

Publication History

Received: 06 August 2025

Accepted after revision: 02 January 2026

Article published online:
20 January 2026

• References

• 1 Cotelingam JD, Saito R. Hepatolienal fusion: case report of an unusual lesion. Human pathology 1978; 9: 234-236
• 2 Al-Salem AH. The Spleen: Anatomy, Physiology and diseases. 1st ed. Singapore: Springer Nature Singapore; Imprint Springer; 2023
• 3 Wang KSD. Hepatolienal fusion: a rare case report. Poster No. 88: Abstracts and Case Studies From the College of American Pathologists. Arch Pathol Lab Med 2017;
• 4 Blakaj F, Haliti D, Kotori V. et al. Hepatolienal fusion combined with Eagle syndrome: A rare case report. Forensic Science International: Reports 2020; 2: 100087