Abstract
A 45-year-old woman was detected to have a cystic lesion at the tail of the pancreas by abomominal ultrasonography in a routine physical examination. She consulted a general physician who, diagnosised it as benign lesion, and recommended to follow the clinical course. Six months later, the tumor increased in size and she was admitted to our hospital for close exprolation. Computed tomography (CT) showed a cystic lesion 2.0cm in diameter in the pancreas tail, and the well enhanced cystic wall. On T1-weighted magnetic resonance imaging (MRI), the cystic lesion showed a low intensity shadow, and T2-weighted MRI showed an iso-intensity shadow. Since a possibility of malignant disease could not be ruled out, operation was performed. The cystic lesion was 2.0cm in diameter and unilocular, and contained a brown serous fluid. Histopathologic study of the frozen section during the operation confirmed it to be an epidermoid cyst in an accessory spleen at the pancreatic tail. Ectopic splenic tissue in the abdominal cavity is a common entity. However, intrapancreatic accessory spleen is rare, especially cyst formation in it. It could be misdiagnosed as cystic tomor or pseudocyst of the pancreatic tail, thus differential diagnosis would be required. We report this rare case of cyst formation in an intrapancreatic accessory spleen.
