BMJ Case Reports 2013; doi:10.1136/bcr-2012-008471

Intrapancreatic accessory spleen: a misleading diagnosis

  1. José Pedro Penedo1
  1. 1Department of Radiology, Portuguese Institute of Oncology of Lisbon, Lisbon, Portugal
  2. 2Department of Gastroenterology and Hepatology, Hospital Santa Maria, Lisbon, Portugal
  1. Correspondence to Dr Alexandre Oliveira Ferreira, alex.fsof{at}


Intrapancreatic accessory spleens are congenital malformations that occur in roughly 2% of individuals. Most of them are innocent until found. Lately, there have been a few case reports of intrapancreatic spleen misdiagnosis leading to unnecessary pancreatic surgery. We report the case of a 64-year-old woman who had a hypervascular pancreatic nodule diagnosed on dynamic CT and MRI after an episode of acute pancreatitis. The patient's progress was followed for 18 months, repeated the CT and MRI examinations and an endoscopic ultrasonography with fine needle aspiration was performed. Neoplastic cells were not identified on cytology. Despite the stability of the lesion,  a distal pancreatectomy was performed to exclude a neuroendocrinal tumour. An intrapancreatic accessory spleen was ultimately identified on histological examination.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article