Epithelial cyst in an intrapancreatic accessory spleen – a case report
Authors:
Radek Pohnán; M. Ryska
Authors‘ workplace:
Chirurgická klinika 2. LF UK a ÚVN Praha, přednosta: prof. MUDr. M. Ryska, CSc.
Published in:
Rozhl. Chir., 2013, roč. 92, č. 12, s. 726-728.
Category:
Case Report
Overview
Introduction:
Accessory spleen is a relatively common congenital defect with a 10% incidence in the population. Intrapancreatic accessory spleens are rare and cystic formation may mimic a hypervascular pancreatic tumour.
Case report:
We present the case of a 27-year-old woman who underwent abdominal ultrasonography (USG) because of chronic abdominal discomfort. USG findings revealed a 20 mm cystic mass in the tail of the pancreas. Additional preoperative investigations showed a tumour in the tail of the pancreas suspected of being a non-active neuroendocrine tumour. The intraoperative finding was a hard mass in the tail of the pancreas and neither peritoneal dissemination nor metastasis was detected. Distal pancreatectomy was performed. Pathological examination described an epithelial cyst in an intrapancreatic accessory spleen.
Discussion:
Cyst formation in an intrapancreatic accessory spleen is extremely rare. Most patients with this condition have no clinical symptoms and it is often detected incidentally by imaging studies. It is difficult to differentiate an epithelial splenic cyst in the pancreas from a primary pancreatic neoplasm because it lacks particular characteristics on radiological examination; epithelial splenic cysts should be considered in the differential diagnosis of a cystic lesion in the tail of the pancreas.
Key words:
spleen – epithelial cyst – intrapancreatic accessory spleen
Sources
1. Freeman JL, Jafri SZ, Roberts JL, et al. CT of congenital and acquired abnormalities of the spleen. Radiographics 1993;13: 597–610.
2. Dodds WJ, Taylor AJ, Erickson SJ, et al. Radiologic imaging of splenic anomalies. Am J Roentgenol 1990;155:805–810.
3. Chin S, Isomoto H, Mizuta Y, et al. Enlarged accessory spleen presenting stomach submucosal tumor. World J Gastroenterol 2007;13:1752–1754.
4. Zhang Z, Wang JC. An Epithelial Splenic Cyst in an Intrapancreatic Accessory Spleen. A Case Report. J Pancreas 2009;10: 664–666.
5. Gayer G, Zissin R, Apter S, et al. CT findings in congenital anomalies of the spleen. Br J Radiol 2001;74:767–772.
6. Halpert B, Gyorkey F. Lesions observed in accessory spleens of 311 patients. Am J Clin Pathol 1959;32:165–168.
7. Hamada T, Isaji S, Mizuno S, et al. Laparoscopic spleen-preserving pancreatic tail resection for an intrapancreatic accessory spleen mimicking a nonfunctioning endocrine tumor: report of a case. Surg Today 2004;34:878–881.
8. Sica GT, Reed MF. Case 27: intrapancreatic accessory spleen. Radiology 2000;217:134–137.
9. Harris GN, Kase DJ, Bradnock H, McKinley MJ. Accessory spleen causing a mass in the tail of the pancreas: MR imaging findings. Am J Roentgenol 1994;163:1120–1121.
10. Nakae Y, Hayakawa T, Kondo T, et al. Epidermoid cyst occurring in a pancreatic accessory spleen. J Clin Gastroenterol 1991;13:362–4.
11. Tang X, Tanaka Y, Tsutsumi Y. Epithelial inclusion cysts in an intrapancreatic accessory spleen. Pathol Int 1994;44:652–4.
12. Higaki K, Jimi A, Watanabe J, et al. Epidermoid cyst of the spleen with CA19-9 or carcinoembryonic antigen productions:report of three cases. Am J Surg Pathol 1998;22:704–8.
13. Furukawa H, Kosuge T, Kanai Y, Mukai K. Epidermoid cyst in an intrapancreatic accessory spleen: CT and pathologic findings. Am J Roentgenol 1998;171:271.
14. Choi SK, Ahn SI, Hong KC, et al. A case of epidermoid cyst of the intrapancreatic accessory spleen. J Korean Med Sci 2000;15:589–92.
15. Sonomura T, Kataoka S, Chikugo T, et al. Epidermoid cyst originating from an intrapancreatic accessory spleen. Abdom Imaging 2002;27:560–2.
16. Kanazawa H, Kamiya J, Nagino M, et al. Epidermoid cyst in an intrapancreatic accessory spleen: a case report. J Hepatobiliary Pancreat Surg 2004;11:61–63.
17. Itano O, Shiraga N, Kouta E, et al. Epidermoid cyst originating from an intrapancreatic accessory spleen. J Hepatobiliary Pancreat Surg 2008;15:436–439.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
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