Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
School of Humanities and Social Sciences, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
Pancreatology. 2019 Jan;19(1):10-16. doi: 10.1016/j.pan.2018.10.008. Epub 2018 Oct 22.
BACKGROUND/OBJECTIVES: Due to its rarity, epidermoid cyst in intrapancreatic accessory spleen (ECIPAS) is still a diagnostic dilemma during clinical practice. The aim of this review was to summarize the epidemiologic features and management of ECIPAS.
MEDLINE and EMBASE were searched for English articles reporting on ECIPAS up to April 30th, 2018 following the methodology suggested by the PRISMA guidelines. Categorical variables were reported as frequency and percentage. Continuous variables were reported as median (range).
A total of 56 patients from 47 full articles were included for the final data synthesis. More than half of the ECIPASs (59%) were found incidentally. The female/male ratio was 1.33. ECIPAS is typically a single mono-/multi-lobular cystic lesions in the pancreatic tail with thickened cystic wall or various amount of solid component which had identical density/signal to the spleen on imaging examinations. The cyst is filled with serous or non-serous fluid. Recognition of the surrounding ectopic splenic tissue is the key point to diagnose ECIPAS. However, no preoperative examination was able to make a definite diagnosis. Almost all the patients (96%) received surgical treatment, due to the suspicion of pancreatic malignant or potentially malignant cystic tumor, especially mucinous cystic neoplasm (MCN).
Although seldom encountered, ECIPAS should be considered as a differential diagnosis for pancreatic cystic lesions, especially when solid component was detected. As a benign disease, unnecessary surgery should be avoided. Because it is difficult to make a definite diagnosis preoperatively by one single examination, multiple modalities may be required.
背景/目的：由于其罕见性，胰腺内副脾表皮样囊肿（ECIPAS）在临床实践中仍然是一个诊断难题。本综述的目的是总结 ECIPAS 的流行病学特征和处理方法。
按照 PRISMA 指南建议的方法，检索 MEDLINE 和 EMBASE 数据库，以获取截至 2018 年 4 月 30 日关于 ECIPAS 的英文文献。分类变量以频率和百分比报告。连续变量以中位数（范围）报告。
共有 47 篇全文中的 56 例患者纳入最终的数据综合分析。超过一半的 ECIPAS（59%）是偶然发现的。女性/男性比例为 1.33。ECIPAS 通常是胰腺尾部的单个单/多叶囊性病变，伴有增厚的囊性壁或各种量的实性成分，在影像学检查上与脾脏密度/信号相同。囊肿内充满浆液或非浆液性液体。识别周围异位脾组织是诊断 ECIPAS 的关键。然而，术前检查均无法做出明确诊断。由于怀疑胰腺恶性或潜在恶性囊性肿瘤，特别是黏液性囊腺瘤（MCN），几乎所有患者（96%）都接受了手术治疗。
尽管很少见，但 ECIPAS 应被视为胰腺囊性病变的鉴别诊断之一，特别是当检测到实性成分时。由于该病术前很难通过单一检查做出明确诊断，可能需要多种方法。
