Abstract
The estimated prevalence of accessory spleen, most commonly found at the splenic hilum, is about 10% in the autopsy studies. The second commonly involved site is pancreas, and 1-2% of general population has intra-pancreatic accessory spleen (IPAS). Differential diagnosis of IPAS includes other solid pancreatic tumors, especially non-functioning pancreatic neuroendocrine tumors. Computed tomography scans and diffusion-weighted magnetic resonance imaging may accurately distinguish IPAS from other solid pancreatic lesions, with imaging features similar to the native spleen. Epidermoid cysts (EC) are common in the native spleen, but rarely found in IPAS. Differential diagnosis of the EC in IPAS includes other cystic lesions of the pancreas. Although the condition is extremely rare, an accurate pre-operative diagnosis can save a patient from major surgery given the benign nature of this condition. We present a case of an EC in an IPAS who underwent distal pancreatectomy with splenectomy for suspicion of malignancy.
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