Epidermoid cyst in intrapancreatic accessory spleen: A systematic review

Li, Bing‐Qi; Lü, Jun; Seery, Samuel; Guo, Junchao

doi:10.1016/j.pan.2018.10.008

Cited by 15 publications

(24 citation statements)

References 50 publications

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“…ECIPAS was first reported in 1980 by Davidson et al [ 4 ] Since then, a total of 59 cases have been reported in the English-language literature [ 4 – 42 ]. According to Li et al [ 43 ] ECIPAS is more common in women, with all cases located in the pancreatic tail, and more than half of the cases were asymptomatic and found incidentally.…”

Section: Discussionmentioning

confidence: 99%

Epithelial cyst arising in an intrapancreatic accessory spleen: a case report of robotic surgery and review of minimally invasive treatment

et al. 2020

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Background An epithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is rare. We report a case of ECIPAS that was treated with robot-assisted distal pancreatectomy with splenectomy. Case presentation The case was a 59-year-old woman who was referred to our hospital after a pancreatic tail tumor was found on computed tomography prior to surgery for small bowel obstruction at another hospital. A cystic lesion in the pancreatic tail was discovered and evaluated by magnetic resonance imaging and endoscopic ultrasonography. Based on clinical and radiological features, mucinous cystic neoplasm was included in the differential diagnosis. The patient underwent robot-assisted distal pancreatectomy with splenectomy. The postoperative course was uneventful. Pathological evaluation revealed a 20-mm ECIPAS in the pancreatic tail. Conclusions If a pancreatic tail tumor is present, ECIPAS should be included in the differential diagnosis. However, preoperative diagnosis is difficult, and a definitive diagnosis is often not obtained until after surgery. Surgery should be minimally invasive. Laparoscopic distal pancreatectomy has become a standard surgical procedure because it is minimally invasive. Robot-assisted surgery is not only minimally invasive, but also advantageous, because it has a stereoscopic magnifying effect and allows the forceps to move smoothly. Robot-assisted distal pancreatectomy may be a good option, when performing surgery for a pancreatic tail tumor.

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Section: Discussionmentioning

confidence: 99%

Epithelial cyst arising in an intrapancreatic accessory spleen: a case report of robotic surgery and review of minimally invasive treatment

et al. 2020

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“…Reported serum CA 19-9 levels were elevated in 20 of 37 patients. 11 Despite these findings, there is insufficient data to conclude significance of these biomarkers in epidermoid cystic IPAS.…”

Section: Discussionmentioning

confidence: 99%

Intrapancreatic Accessory Spleen Masquerading as a Pancreatic Mucinous Neoplasm

2020

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AbstractIncidentally discovered pancreatic cysts have become more common with increasing use of abdominal cross-sectional imaging. Tools that help us to better risk stratify a pancreatic cyst include advanced imaging techniques, such as pancreatic protocol computed tomography (CT) scan or magnetic resonance imaging (MRI) with cholangiopancreatography. Endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) are invasive measures to better define and sample cysts especially if high-risk features are present. EUS may also yield pancreatic cyst fluid for analysis of carcinoembryonic antigen (CEA) which is elevated in mucinous cysts. This case highlights a rare finding of a mucinous, epidermoid cyst in an intrapancreatic accessory spleen (IPAS) with high-risk features on EUS.

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“…Epidermoid cyst within an intrapancreatic accessory spleen (ECIAS) is a rare, benign disease that does not require resection; however, most patients with ECIAS undergo distal pancreatectomy because of challenges in the accurate diagnosis without histopathological examination. Several retrospective analyses of the clinical characteristics of ECIAS suggest that the detection of solid components relevant to an accessory spleen might be a key diagnostic finding [1,2], whereas few cases are preoperatively diagnosed and closely observed based on such findings [3,4]. However, some studies have reported ECIAS in patients without the findings of an accessory spleen [1,5].…”

Section: Introductionmentioning

confidence: 99%

“…Several retrospective analyses of the clinical characteristics of ECIAS suggest that the detection of solid components relevant to an accessory spleen might be a key diagnostic finding [1,2], whereas few cases are preoperatively diagnosed and closely observed based on such findings [3,4]. However, some studies have reported ECIAS in patients without the findings of an accessory spleen [1,5]. Additionally, patients with ECIAS might display high serum levels of carbohydrate antigen (CA) 19-9, suggesting malignancy [3,5].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, patients with ECIAS might display high serum levels of carbohydrate antigen (CA) 19-9, suggesting malignancy [3,5]. In these cases, it is challenging to distinguish ECIAS from malignancies including mucinous cystic neoplasms and intraductal papillary mucinous neoplasms [1,2]. Therefore, accumulation of cases is warranted, especially in patients with ECIAS who do not display findings of solid components on radiological examinations.…”

Section: Introductionmentioning

confidence: 99%

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Epidermoid cyst within an intrapancreatic accessory spleen exhibiting abrupt changes in serum carbohydrate antigen 19-9 level: a case report

et al. 2020

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Background: Epidermoid cyst within an intrapancreatic accessory spleen (ECIAS) is a rare disease. While the detection of solid components relevant to an accessory spleen is a key diagnostic finding, the differential diagnosis between ECIAS and malignant tumors is difficult without resection in patients with no other findings of an accessory spleen. Case presentation: A 73-year-old male was found to have an elevated carbohydrate antigen (CA) 19-9 level (95 U/mL) at an annual checkup, and a cystic lesion in the pancreatic tail was located by abdominal ultrasound. Abdominal magnetic resonance imaging (MRI) revealed a multicystic mass, 24 mm in diameter, which exhibited varying intensities on T2-weighted images. There were no findings suggesting solid components on contrast-enhanced computed tomography and magnetic resonance imaging. Re-evaluation of serum CA 19-9 level revealed a rapid increase to 901 U/mL, which declined to 213 U/mL 3 weeks later. Ruling out the lesion's malignant potential was difficult, and the patient underwent distal pancreatectomy with splenectomy. Histological findings revealed an ECIAS including multiple cysts, with the mucinous component of each cyst exhibiting different stages of biological reaction; one ruptured cyst exhibited inflammatory changes. Conclusions: Careful observation for changes in serum CA 19-9 level and MRI findings might facilitate the diagnosis of ECIAS without a solid component by imaging studies.

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Epidermoid cyst in intrapancreatic accessory spleen: A systematic review

Cited by 15 publications

References 50 publications

Epithelial cyst arising in an intrapancreatic accessory spleen: a case report of robotic surgery and review of minimally invasive treatment

Epithelial cyst arising in an intrapancreatic accessory spleen: a case report of robotic surgery and review of minimally invasive treatment

Intrapancreatic Accessory Spleen Masquerading as a Pancreatic Mucinous Neoplasm

Epidermoid cyst within an intrapancreatic accessory spleen exhibiting abrupt changes in serum carbohydrate antigen 19-9 level: a case report

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