Meiler R, Dietl K-H, Novák K, Patzel C
Department of General, Visceral, and Thoracic Surgery, Klinikum Weiden, Weiden, Germany.
Int Surg. 2010 Apr-Jun;95(2):183-7.
Intrapancreatic accessory spleen is a rare cause of pancreatic pseudotumors and is located in the pancreatic tail in approximately 1% to 2%. Accessory spleen itself is found in approximately 7% to 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 cholecystitis was incidentally diagnosed with a tumor at the pancreatic tail. On hyperintense magnetic resonance imaging, a solid mass of 1.5 cm in diameter in the pancreatic tail was seen, which contrasted as hyperdense in T2-weighted imaging. Because of inhomogeneous enhancement on the early vascular phase, the diagnosis of a endocrine pancreatic tail carcinoma was suspected. Intraoperatively, an accessory spleen was found in the pancreatic tail. An oncologic left pancreatectomy was performed because of a malignant tumor. Histology showed an intrapancreatic accessory spleen in the pancreatic tail that excluded the presence of cancer. In conclusion, intrapancreatic accessory spleen is a rare cause of unnecessary laparotomy, but the absence of reliable diagnostics for this entity make histologic ascertainment of a benign tumor indispensable. Therefore, we still needed an oncologic tumor resection.
胰腺内副脾是胰腺假性肿瘤的罕见病因，约1%至2%位于胰尾。副脾本身在约7%至15%的人群中可见。我们的研究结果显示了一例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岁男性偶然被诊断出胰尾有肿瘤。在高信号磁共振成像上，可见胰尾有一个直径1.5厘米的实性肿块，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。因恶性肿瘤进行了肿瘤性左胰腺切除术。组织学检查显示胰尾有一个胰腺内副脾，排除了癌症的存在。总之，胰腺内副脾是不必要剖腹手术的罕见原因，但针对该实体缺乏可靠的诊断方法使得对良性肿瘤进行组织学确诊必不可少。因此，我们仍需要进行肿瘤性肿瘤切除。
