Epidermoid cyst within an intrapancreatic accessory spleen exhibiting abrupt changes in serum carbohydrate antigen

Related Experiment Video

Updated: Aug 9, 2026

Robotic Spleen-Preserving Distal Pancreatectomy: The Warshaw and Kimura Techniques
07:33

Robotic Spleen-Preserving Distal Pancreatectomy: The Warshaw and Kimura Techniques

Published on: July 26, 2024

2.9K

Chisato Takagi1, Nobuo Hoshi2, Yutaro Kikuchi3

  • 1Department of Hepato-Biliary-Pancreatic Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, Tochigi, 320-0834, Japan. chtakagi@tochigi-cc.jp.

Surgical Case Reports
|June 14, 2020
PubMed

Insights

Epidermoid cyst within an intrapancreatic accessory spleen (ECIAS) is rare. Careful monitoring of serum CA 19-9 levels and MRI findings may help diagnose ECIAS without solid components, avoiding unnecessary surgery.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Diagnostic Imaging

Background:

  • Epidermoid cyst within an intrapancreatic accessory spleen (ECIAS) is an uncommon condition.
  • Distinguishing ECIAS from malignant pancreatic tumors can be challenging without surgical resection, especially when solid components are absent.

Purpose of the Study:

  • To highlight the diagnostic challenges of ECIAS.
  • To explore imaging and serological markers for non-invasive ECIAS diagnosis.

Main Methods:

  • A case report of a 73-year-old male with an incidentally discovered cystic pancreatic tail lesion.
  • Utilized abdominal ultrasound, MRI, and serum carbohydrate antigen (CA) 19-9 monitoring.
  • Surgical resection (distal pancreatectomy with splenectomy) and subsequent histopathological examination.

Main Results:

  • The patient presented with fluctuating CA 19-9 levels and a multicystic pancreatic mass on MRI without solid components.
  • Histopathology confirmed ECIAS with varying stages of mucinous cyst reaction and inflammation.
  • The final diagnosis of ECIAS was established post-resection.

Conclusions:

  • ECIAS diagnosis can be challenging due to its rarity and lack of solid components.
  • Serial monitoring of CA 19-9 levels and serial MRI may aid in differentiating ECIAS from malignant lesions.
  • Non-invasive diagnostic strategies are crucial for avoiding unnecessary pancreatic surgery.
Abstract

Keywords:
CA 19-9 antigenEpidermoid cystIntrapancreatic accessory spleen

More Related Videos

Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis03:42

Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis

Published on: March 15, 2024

974
Laparoscopic Posterior Radical Antegrade Modular Pancreatosplenectomy for Distal Pancreatic Carcinoma03:55

Laparoscopic Posterior Radical Antegrade Modular Pancreatosplenectomy for Distal Pancreatic Carcinoma

Published on: December 29, 2023

907

Related Concept Videos

Acute Pancreatitis II: Clinical Manifestations and Management01:30

Acute Pancreatitis II: Clinical Manifestations and Management

Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Acute Pancreatitis I: Introduction01:25

Acute Pancreatitis I: Introduction

Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
Acute Pancreatitis II: Pathophysiology01:21

Acute Pancreatitis II: Pathophysiology

The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...
Chronic Pancreatitis I: Introduction01:25

Chronic Pancreatitis I: Introduction

Chronic pancreatitis is a long-standing, relapsing inflammation of the pancreas, characterized by irreversible damage to the gland. It results in progressive destruction of the pancreatic parenchyma, fibrosis, and eventual loss of both exocrine and endocrine function. The disease may evolve gradually after multiple episodes of acute pancreatitis or develop independently.EtiologyChronic pancreatitis can arise from a variety of causes:Alcohol use is the leading cause, accounting for 70–80% of...