Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1973
Peer-review started: August 25, 2021
First decision: October 27, 2021
Revised: November 2, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: February 26, 2022
Processing time: 182 Days and 3.8 Hours
Intrapancreatic accessory spleen (IPAS) is an uncommon condition, with the majority of cases presenting as solid lesions. Thus, this condition is frequently misdiagnosed as pancreatic solid neoplasm. Moreover, splenic cavernous hemangioma is a rare disorder, whereas lesions with a cystic appearance arising from IPAS have not been reported.
Herein, we present a case involving a 32-year-old male who had a complex cystic lesion in the tail of the pancreas revealed by conventional ultrasound. The lesion was misdiagnosed as a pancreatic cystadenoma because of its confusing anatomic location, as well as due to its peripheral nodular and internal septal enhancement patterns on contrast-enhanced ultrasound. After multidisciplinary discussion, the patient finally underwent laparoscopic pancreatic body and tail resections. Postoperative pathology demonstrated the lesion to be a cavernous hemangioma arising from the IPAS.
Cavernous hemangioma in the intrapancreatic accessory spleen may mimic pancreatic cystadenoma, which is a condition with the potential to be malignant. Imaging follow-ups or surgical interventions may be helpful for the exclusion of malignant risks in complicated cystic lesions, especially those with parietal and septal enhancements.
Core Tip: Intrapancreatic accessory spleen (IPAS) is an uncommon condition; however, overlapping imaging manifestations of IPAS and pancreatic tumors may lead to unnecessary surgery. Cystic splenic cavernous hemangioma is a rare disorder, whereas lesions with a cystic appearance arising from IPAS have not been reported. Herein, we report a cavernous hemangioma in the IPAS that was misdiagnosed as being a pancreatic cystadenoma via contrast-enhanced modalities. The diagnosis of cystic lesions in IPAS can be challenging. Imaging follow-ups or surgical interventions may be needed for the possible malignancy risk of a complicated cystic lesion, especially those with parietal and septal enhancements.