Panagiotopoulos Nikolaos, Acharya Metesh, Ahmad Raida, Bansi Devinder, Jiao Long
Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0HS, United Kingdom.
Int J Surg Case Rep. 2012;3(3):118-20. doi: 10.1016/j.ijscr.2011.12.005. Epub 2011 Dec 29.
An accessory spleen (splenunculus) may occur in up to 10% of the general population. However, an epithelial inclusion cyst originating within an intra-pancreatic splenunculus is an extremely rare finding, with only twenty-two previous cases described in medical literature.
A 51-year-old male presented to our institution for investigation of altered bowel habit. Endoscopic ultrasound examination and CT scanning demonstrated an 18 mm cystic, well-demarcated lesion in the tail of the pancreas, resembling malignancy. Following laparoscopic spleen-preserving distal pancreatectomy, histological analysis confirmed epithelial inclusion cyst arising within an intra-pancreatic splenunculus.
The pre-operative radiological identification of such cystic pancreatic lesions is challenging. Surgical resection is usually performed for clinical suspicion of pancreatic malignancy.
Epithelial inclusion cyst originating within an intra-pancreatic accessory spleen is an extremely rare finding, which can mimic malignancy. Nevertheless, it should be carefully considered in the differential diagnosis of cystic lesions of the tail of the pancreas.
副脾在普通人群中的发生率可达10%。然而,起源于胰腺内副脾的上皮包涵囊肿极为罕见,医学文献中仅描述过22例此前病例。
一名51岁男性因排便习惯改变到我院就诊。内镜超声检查和CT扫描显示胰腺尾部有一个18毫米的囊性、边界清晰的病变,类似恶性肿瘤。在进行腹腔镜保留脾脏的远端胰腺切除术后,组织学分析证实为起源于胰腺内副脾的上皮包涵囊肿。
术前对这类胰腺囊性病变进行放射学鉴别具有挑战性。通常因临床怀疑胰腺恶性肿瘤而进行手术切除。
起源于胰腺内副脾的上皮包涵囊肿极为罕见,可酷似恶性肿瘤。尽管如此,在胰腺尾部囊性病变的鉴别诊断中应仔细考虑。