title: Ectopic spleen and liver hemangioma mimicking metastatic pancreatic neuroendocrine tumor.
abstract: Pancreatic tumors comprise benign lesion and malignant lesion, most importantly pancreatic adenocarcinoma, acinar cell carcinoma, neuroendocrine carcinoma or metastasis. Surgical resection provides the only chance for cure for malignant pancreatic tumors. In some cases, surgical resection is performed because a malignant lesion is suspected, however, histopathological examinations eventually reveal a benign lesion. Here, we report the case of a 49-year-old woman, who was initially diagnosed with a neuroendocrine tumor of the pancreas with metastasis to the liver. The patient underwent distal pancreatectomy and atypical liver resection. Surprisingly, however, histopathological examination revealed an intrapancreatic accessory spleen (IPAS) of the pancreatic tail as well as liver hemangioma. This unique case report highlights the impact of extensive preoperative examinations to differentiate benign and malignant pancreatic lesions and, possibly, prevent patients from unnecessary surgery.
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Christine C
authors.initials: CC
authors.lastname: Engler
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Lemke
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Marko
authors.initials: M
authors.lastname: Kornmann
authors.affiliation: Institute of Pathology, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Barth
authors.affiliation: Department of Diagnostic and Interventional Radiology, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Schmidt
authors.affiliation: Clinic of General and Visceral Surgery, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany. Electronic address: doris.henne-bruns@uniklinik-ulm.de.
authors.forename: Doris
authors.initials: D
authors.lastname: Henne-Bruns
keywords: Intrapancreatic accessory spleen; Liver hemangioma; Metastasis; Pancreatic neuroendocrine tumor