Intrapancreatic accessory spleen.
Intrapancreatic accessory spleen is a rare cause of pancreatic pseudotumors and is located in the pancreatic tail in approximately 1% to 2%. Accessory spleen itself is found in approximately 7% to 15% of the population. Our findings show a case of an intrapancreatic accessory spleen suspected for a malignancy in the pancreatic tail. A 63-year-old man admitted for cholecystitis was incidentally diagnosed with a tumor at the pancreatic tail. On hyperintense magnetic resonance imaging, a solid mass of 1.5 cm in diameter in the pancreatic tail was seen, which contrasted as hyperdense in T2-weighted imaging. Because of inhomogeneous enhancement on the early vascular phase, the diagnosis of a endocrine pancreatic tail carcinoma was suspected. Intraoperatively, an accessory spleen was found in the pancreatic tail. An oncologic left pancreatectomy was performed because of a malignant tumor. Histology showed an intrapancreatic accessory spleen in the pancreatic tail that excluded the presence of cancer. In conclusion, intrapancreatic accessory spleen is a rare cause of unnecessary laparotomy, but the absence of reliable diagnostics for this entity make histologic ascertainment of a benign tumor indispensable. Therefore, we still needed an oncologic tumor resection.
Meiler
R
R
Department of General, Visceral, and Thoracic Surgery, Klinikum Weiden, Weiden, Germany. r.meiler@web.de
Dietl
K-H
KH
Novák
K
K
Patzel
C
C
D015746:Abdominal Pain / Q000209:etiology; D002769:Cholelithiasis / Q000601:surgery; D002828:Choristoma / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D013154:Spleen; D014057:Tomography, X-Ray Computed