[Epithelial cyst in an intrapancreatic accessory spleen -a case report]

Accessory spleen is a relatively common congenital defect with a 10% incidence in the population. Intrapancreatic accessory spleens are rare and cystic formation may mimic a hypervascular pancreatic tumour.

We present the case of a 27-year-old woman who underwent abdominal ultrasonography (USG) because of chronic abdominal discomfort. USG findings revealed a 20 mm cystic mass in the tail of the pancreas. Additional preoperative investigations showed a tumour in the tail of the pancreas suspected of being a non-active neuroendocrine tumour. The intraoperative finding was a hard mass in the tail of the pancreas and neither peritoneal dissemination nor metastasis was detected. Distal pancreatectomy was performed. Pathological examination described an epithelial cyst in an intrapancreatic accessory spleen.

Cyst formation in an intrapancreatic accessory spleen is extremely rare. Most patients with this condition have no clinical symptoms and it is often detected incidentally by imaging studies. It is difficult to differentiate an epithelial splenic cyst in the pancreas from a primary pancreatic neoplasm because it lacks particular characteristics on radiological examination; epithelial splenic cysts should be considered in the differential diagnosis of a cystic lesion in the tail of the pancreas. Key words: spleen - epithelial cyst - intrapancreatic accessory spleen.