title: Laparoscopic resection of an epidermoid cyst originating from an intrapancreatic accessory spleen: report of a case.
abstract: A 67-year-old man underwent an investigation of epigastric pain and weight loss. Preoperative imaging findings suggested the presence of a tumor, which developed as an epidermoid cyst and originated from an intrapancreatic accessory spleen; however, the possibility of malignancy could not be ruled out. We therefore performed a laparoscopic-assisted distal pancreatectomy with a splenectomy for both diagnostic and treatment purposes. Five laparoscopic ports were created. After the spleen and pancreatic tail were dissected from the retroperitoneum laparoscopically, they were pulled out through a 7-cm left subcostal incision and resected with an endoscopic linear stapler. The operative time was 227 min and the blood loss was 400 ml. The postoperative course was uneventful. The final pathological diagnosis was in agreement with the preoperative diagnosis. This case demonstrates that the minimally invasive approach of laparoscopic surgery can be used safely and successfully for difficult-to-diagnose pancreatic tumors. This is the first report describing a laparoscopic resection of an epidermoid cyst originating from an intrapancreatic accessory spleen.
authors.affiliation: Endoscopic Surgery Center, Eiju General Hospital, 2-23-16 Higashiueno, Taito-ku, Tokyo, 110-8645, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Itano
authors.forename: Naokazu
authors.initials: N
authors.lastname: Chiba
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Wada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yuasa
authors.forename: Teiko
authors.initials: T
authors.lastname: Sato
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Koyama
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsui
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000368:Aged; D002828:Choristoma / Q000150:complications / Q000601:surgery*; D004814:Epidermal Cyst / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D010180:Pancreatectomy / Q000379:methods; D010182:Pancreatic Diseases / Q000150:complications* / Q000601:surgery; D013154:Spleen; D013156:Splenectomy / Q000379:methods; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014463:Ultrasonography; D015431:Weight Loss