Intrapancreatic accessory spleen

Background: Intrapancreatic accessory spleen is a rare cause of pancreatic pseudotumors and in about 1-2% located in the pancreatic tail. Accessory spleens itself are found in about 10-15% of the population. Our findings show a case of an intrapancreatic accessory spleen suspected for a malignancy in the pancreatic tail.

Methods: A 63-year-old man admitted for Cholezystitis was incidencially diagnosed with a tumor at the pancreatic tail. On MRI a hyperintense solid mass of 1.5 cm in diameter in the pancreatic tail was seen, which contrasted hyperdense in T2-weighted imaging. Due to inhomogenous enhancement on the early vascular phase the diagnosis of a endocrine pancreatic tail Carcinoma was suspected.

Results: Intraoperative an accessory spleen was found in the pancreatic tail. An oncological left pancreatectomy was performed suspecting a malignant tumor. Histology showed an intrapancreatic accessory spleen in the pancreatic tail excluding presence of cancer.

Conclusions: Intrapancreatic accessory spleen is a rare cause of unnecessary laparotomy but the absence of reliable diagnostics for this entity make histological ascertainment of a benign tumor indispensable. Therefore we still need an oncological tumor resection.