Intrapancreatic accessory spleen

Case contributed by Mohammad Taghi Niknejad
Diagnosis probable

Presentation

Incidental finding.

Patient Data

Age: 35 years
Gender: Female

A 20 mm well-defined partially exophytic oval homogeneous mass is noted in the anterior aspect of the pancreatic tail. The enhancement pattern follows that of the spleen, and the mass obtains blood supply from branche off of the splenic artery and drainage into the splenic vein.

An IUCD is present within the uterine cavity in the appropriate location.

Case Discussion

This case demonstrates an intrapancreatic accessory spleen, an uncommon condition in which a small accessory spleen is found within the pancreas parenchyma and can sometimes be mistaken for a pancreatic tumor in imaging studies.

Accessory spleens are mainly located near the spleen. However, they have been identified elsewhere in the abdominal cavity, including the pancreatic tail, greater omentum, small bowel mesentery, and stomach or bowel wall 1.

Intrapancreatic accessory spleens are usually 1-2 cm in size, structurally resembling the spleen, and fed by splenic artery branches. The anterior aspect of the pancreatic tail is the most common location. They can mimic hypervascular pancreatic tumors like acinar cell carcinomas and neuroendocrine tumors on imaging studies such as ultrasound, MRI, and CT 2.

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