doiSerbia

Laparoscopic distal pancreatectomy for intrapancreatic accessory spleen: Case report

Matić Slavko (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Digestive Surgery, Belgrade)
Knežević Đorđe (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Digestive Surgery, Belgrade)
Ignjatović Igor (Clinical Center of Serbia, Clinic for Digestive Surgery, Belgrade)
Grubor Nikola (Clinical Center of Serbia, Clinic for Digestive Surgery, Belgrade)
Dugalić Vladimir (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Digestive Surgery, Belgrade)
Micev Marjan (Clinical Center of Serbia, Clinic for Digestive Surgery, Belgrade)
Knežević Srbislav (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Digestive Surgery, Belgrade)

Introduction. Accessory spleens can be found in up to 10% of the population, and their intrapancreatic occurrence is considered uncommon. When present, the intrapancreatic accessory spleen is usually found in the tail of the pancreas in about 1.7% of adult individuals. The infrequent presence of the accessory spleen in the pancreatic tissue could lead to inappropriate diagnosis and hence therapeutic approach, as they are commonly presented as a hypervascular node in the tail of the pancreas on abdominal CT and MRI, mimicking a well differentiated tumor of the pancreas or non-functioning pancreatic neuroendocrine tumor. Case Outline. We present a 70-year-old female in whom a preoperative evaluation finding was highly suggestive of a non-functioning neuroendocrine tumor of the pancreatic tail. We performed spleen preserving laparoscopic distal pancreatectomy, and histopathological examination revealed the intrapancreatic accessory spleen. Conclusion. Although infrequent, the presence of the intrapancreatic accessory spleen must be considered in the differential diagnosis of pancreatic tail tumors.

Keywords: intrapancreatic spleen, accessory spleen, pancreas, pancreatic neuroendocrine tumor, laparoscopicdistal pancreatectomy