Cavernous hemangioma of an intrapancreatic accessory spleen mimicking a pancreatic tumor: A case report

Abstract

BACKGROUND Intrapancreatic accessory spleen (IPAS) is an uncommon condition, with the majority of cases presenting as solid lesions. Thus, this condition is frequently misdiagnosed as pancreatic solid neoplasm. Moreover, splenic cavernous hemangioma is a rare disorder, whereas lesions with a cystic appearance arising from IPAS have not been reported. CASE SUMMARY Herein, we present a case involving a 32-year-old male who had a complex cystic lesion in the tail of the pancreas revealed by conventional ultrasound. The lesion was misdiagnosed as a pancreatic cystadenoma because of its confusing anatomic location, as well as due to its peripheral nodular and internal septal enhancement patterns on contrast-enhanced ultrasound. After multidisciplinary discussion, the patient finally underwent laparoscopic pancreatic body and tail resections. Postoperative pathology demonstrated the lesion to be a cavernous hemangioma arising from the IPAS. CONCLUSION Cavernous hemangioma in the intrapancreatic accessory spleen may mimic pancreatic cystadenoma, which is a condition with the potential to be malignant. Imaging follow-ups or surgical interventions may be helpful for the exclusion of malignant risks in complicated cystic lesions, especially those with parietal and septal enhancements.

Pancreatic cavernous hemangioma complicated with chronic intracapsular spontaneous hemorrhage: A case report and review of literature

“…The term “pancreas hemangioma” was used in a literature search on PubMed and Google Scholar, and relevant papers and their references were examined. In total, 23 works on pCH have been published since 1960[ 1 , 4 - 25 ], including one case of a child[ 6 ]. Finally, 22 cases were enrolled for further analysis.…”

“…Pancreatic cavernous hemangioma (pCH) is an extremely uncommon tumor with no acknowledged typical imaging characteristics in the current literature[ 1 ]. As a result, modern imaging may not sufficiently define this benign illness because hemangiomas closely resemble frequent pancreatic tumors, especially when the pCH is complicated by other clinical conditions.…”