title: A rare diagnosis for a pancreatic mass: splenosis.
abstract: Splenosis, the autotransplantation of splenic tissue, has been designed to preserve organ functions after splenectomy. We present the first case of laparoscopic resection of a pancreatic splenosis, in a patient who had undergone a splenectomy 31 years before, complaining of abdominal pain and diarrhea. Abdominal computed tomography (CT) scan showed an enhancing hypervascular 3-cm solid mass in the body of the pancreas, mimicking a pancreatic cancer or a neuroendocrine tumor. A diagnostic laparoscopy was planned, and a 3-cm peripancreatic nodule with a long pedicle was visualized, with many nodules close to the tail of the pancreas and in the greater omentum. They were all resected, and the specimens obtained were immediately sent for frozen-section examination, which confirmed the diagnosis of heterotopic splenic tissue. Splenosis should be included in the differential diagnosis of the pancreatic masses in patients with previous splenic surgery. A hypervascular mass on CT scan should be regarded as an adenocarcinoma of the pancreas until proven otherwise. The possibility of a neuroendocrine tumor mandates an octreotide scan and gastrointestinal hormones dosage. In the unlikely event that all tests may produce equivocal results, a diagnostic laparoscopy is mandatory, in order to obtain an accurate histopathologic diagnosis.
authors.affiliation: Surgical Unit, S. Martino Hospital, Belluno, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Fiamingo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Veroux
authors.forename: Antonio
authors.initials: A
authors.lastname: Da Rold
authors.forename: Silvio
authors.initials: S
authors.lastname: Guerriero
authors.forename: Stefano
authors.initials: S
authors.lastname: Pariset
authors.forename: Antonino
authors.initials: A
authors.lastname: Buffone
authors.forename: Umberto
authors.initials: U
authors.lastname: Tedeschi
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000209:etiology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D013156:Splenectomy; D017890:Splenosis / Q000175:diagnosis* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed