Intrapancreatic Accessory Spleen Masquerading as a Pancreatic Mucinous Neoplasm

Abstract

Incidentally discovered pancreatic cysts have become more common with increasing use of abdominal cross-sectional imaging. Tools that help us to better risk stratify a pancreatic cyst include advanced imaging techniques, such as pancreatic protocol computed tomography (CT) scan or magnetic resonance imaging (MRI) with cholangiopancreatography. Endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) are invasive measures to better define and sample cysts especially if high-risk features are present. EUS may also yield pancreatic cyst fluid for analysis of carcinoembryonic antigen (CEA) which is elevated in mucinous cysts. This case highlights a rare finding of a mucinous, epidermoid cyst in an intrapancreatic accessory spleen (IPAS) with high-risk features on EUS.

Keywords

pancreatic neoplasm - intrapancreatic accessory spleen - endoscopic ultrasound

Authors' Contributions

S.P. wrote, drafted, and revised the manuscript. S.P. is the guarantor of the case report. S.L. drafted and revised the manuscript. P.K. reviewed pathology, drafted, and revised the manuscript. K.R. drafted and revised the manuscript.

Financial Support

This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

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