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

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}gmail.com

Summary

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.

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