Radiologic findings of intrapancreatic accessory spleen

Abstract

Introduction: Accessory spleen is an anomaly that observed in about 10% of individuals by the autopsy study,and the most of the accessory spleens are located close to the splenic hilum. Although the accessory spleen is a frequently encountered entity, intrapancreatic accessory spleen (IPAS) is rarely recognized radiologically and which is sometimes misdiagnosed pancreatic neoplasms. We present a case of IPAS which radiologically mimicking a pancreatic tumor in the tail of the pancreas. Case report: A 45 year-old man who presented with abdominal pain scanned with abdominal US, CT and MRI. On US a well defined hypoechoic mass, measuring 10x12 mm in diameter that was located in the tail of the pancreas. Enhanced CT showed a well-defined and homogeneously enhanced tumor, about 10 mm in size in the tail of the pancreas. A well-defined 10 mm,solid, enhancing mass was identified on MR images, and for all sequences, was of similar signal intensity as that of the spleen. Discussion: Accessory spleen is a congenital abnormality consisting of normal splenic tissue in ectopic sites. They are found most commonly near the splenic hilum. One in every six accessory spleens is located in the tail of the pancreas. The diagnosis of an IPAS should be considered when a pancreatic mass has the CT densities and/or MRI signal intensities similar to those of the spleen, with and without contrast medium.