Meiler R, Dietl K H, Novák K, Patzel C
Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Klinikum Weiden, Deutschland.
Rozhl Chir. 2009 Apr;88(4):165-9.
Intrapancreatic accessory spleen is a rare cause of pancreatic pseudotumors and in about 1-2% located in the pancreatic tail. Accessory spleens itself are found in about 10-15% of the population. Our findings show a case of an intrapancreatic accessory spleen suspected for a malignancy in the pancreatic tail.
A 63-year-old man admitted for Cholezystitis was incidencially diagnosed with a tumor at the pancreatic tail. On MRI a hyperintense solid mass of 1.5 cm in diameter in the pancreatic tail was seen, which contrasted hyperdense in T2-weighted imaging. Due to inhomogenous enhancement on the early vascular phase the diagnosis of a endocrine pancreatic tail Carcinoma was suspected.
Intraoperative an accessory spleen was found in the pancreatic tail. An oncological left pancreatectomy was performed suspecting a malignant tumor. Histology showed an intrapancreatic accessory spleen in the pancreatic tail excluding presence of cancer.
Intrapancreatic accessory spleen is a rare cause of unnecessary laparotomy but the absence of reliable diagnostics for this entity make histological ascertainment of a benign tumor indispensable. Therefore we still need an oncological tumor resection.
胰腺内副脾是胰腺假性肿瘤的罕见病因，约1%-2%位于胰尾。副脾本身在约10%-15%的人群中可见。我们的研究结果显示了一例位于胰尾、疑似恶性肿瘤的胰腺内副脾病例。
一名因胆囊炎入院的63岁男性在检查时偶然发现胰尾有肿瘤。磁共振成像（MRI）显示胰尾有一个直径1.5厘米的高强度实性肿块，在T2加权成像中呈高密度对比。由于早期血管期强化不均匀，怀疑为内分泌性胰尾癌。
术中在胰尾发现一个副脾。因怀疑是恶性肿瘤，进行了肿瘤根治性左胰腺切除术。组织学检查显示胰尾为胰腺内副脾，排除癌症。
胰腺内副脾是不必要剖腹手术的罕见原因，但由于缺乏针对该实体的可靠诊断方法，对良性肿瘤进行组织学确诊必不可少。因此，我们仍然需要进行肿瘤根治性切除。
