Year 2025 / Volume 117 / Number 11
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Intrapancreatic accessory spleen: there can be smoke without fire

665-666

DOI: 10.17235/reed.2024.10202/2023

Luís Correia Gomes, Margarida Rajão Saraiva, António Figueiredo, Sandra Faias,

Abstract
Case 1: A 69-year-old male underwent magnetic resonance imaging (MRI) to evaluate hepatic hemangiomas that incidentally revealed a homogeneous hypervascular solid nodule (19 mm) in pancreatic tail. Differential diagnosis included neuroendocrine tumor (NET). Normal chromogranin A and CA19.9 levels. PET-68Ga-DOTANOC scan showed pancreatic tail enhancement consistent with NET. Suspicion of neoplasia persisted after two Endoscopic Ultrasounds with Fine-Needle Aspiration without neoplastic cells. Consequently, distal pancreatectomy was performed, revealing an accessory intrapancreatic spleen. Case 2: A 77-year-old female with dyspepsia performed an abdominal CT followed by MRI and both revealed a solid nodule (11.7 mm) in pancreatic tail with regular margins, suggestive of accessory spleen or pancreatic neoplasia. EUS confirmed a hypoechoic, homogeneous nodule consistent with accessory spleen (11.7mm). A scintigraphy using fragile erythrocytes (4) confirmed intrapancreatic accessory spleen, which requires no treatment.
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References
1. Vandekerckhove E, Ameloot E, Hoorens A, De Man K, Berrevoet F, Geboes K. Intrapancreatic accessory spleen mimicking pancreatic NET: can unnecessary surgery be avoided? Acta Clin Belg. 2021 Dec;76(6):492-495. doi: 10.1080/17843286.2020.1762351. Epub 2020 May 12. PMID: 32394810.
2. Lancellotti F, Sacco L, Cerasari S, Bellato V, Cicconi S, Ciardi A, Muttillo EM, Feola T, Caronna R, Chirletti P. Intrapancreatic accessory spleen false positive to 68Ga-Dotatoc: case report and literature review. World J Surg Oncol. 2019 Jul 9;17(1):117. doi: 10.1186/s12957-019-1660-2. PMID: 31288823; PMCID: PMC6617599.
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Gomes L, Saraiva M, Figueiredo A, Faias S. Intrapancreatic accessory spleen: there can be smoke without fire. 10202/2023


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Publication history

Received: 23/12/2023

Accepted: 28/12/2023

Online First: 18/01/2024

Published: 11/11/2025

Article Online First time: 26 days

Article editing time: 689 days


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