Laparoscopic spleen-preserving pancreatic resection for epidermoid cyst in an intrapancreatic accessory spleen: case report and literature review

Zhou, Bo; Zhang, Qiyi; Zhan, Chenchang; Ding, Yuan; Yan, Sheng

doi:10.2147/tcrm.s165489

Cited by 7 publications

(6 citation statements)

References 38 publications

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“…Including the present case, only six (10.7%) among the 56 reported cases were correctly diagnosed preoperatively [15,[19][20][21][22]. Most cases of ECIPAS were diagnosed after surgery based on the pathological ndings [23]. Advances in imaging techniques facilitated the diagnosis of ECIPAS as compared with previously; however, few studies have reported the imaging characteristics of ECIPAS.…”

Section: Discussionmentioning

confidence: 57%

Laparoscopic Spleen-Preserving Distal Pancreatectomy for Epidermoid Cyst in An Intrapancreatic Accessory Spleen: A Case Report

Zheng

Zhou

Sun

et al. 2020

Preprint

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BACKGROUNDPancreatic tail cystic lesions are increasingly encountered in clinical practice, however it is difficult to make a correct diagnosis preoperatively because there are many types of pancreatic neoplastic and non-neoplastic cysts. Epidermoid cyst in an intrapancreatic accessory spleen (ECIPAS) is a rare non-neoplastic cyst and located in the pancreatic tail. Therefore, it should be considered in the differential diagnosis of pancreatic tail cystic lesions. CASE PRESENTATION A 51-year-old man was admitted for investigation of abdominal pain. The physical examination and laboratory tests found no abnormalities, except for an elevation of carbohydrate antigen (CA)19-9. Imaging revealed a 2.6-cm cystic lesion within the pancreatic tail, and the solid component surrounding the cyst was enhanced similarly to those of the splenic tissue. ECIPAS was speculated. With regards to the symptoms and difficulty to completely exclude a malignant tumor, laparoscopic spleen-preserving distal pancreatectomy was performed. The final pathological diagnosis was epidermoid cyst arising from an intrapancreatic accessory spleen. The patient was discharged at day 5 postoperatively after an uneventful recovery. CA19-9 returned to normal after surgery. During 2-years follow-up, there was no evidence of tumor recurrence.CONCLUSIONWe describe typical imaging features of ECIPAS and showed that laparoscopic distal pancreatectomy was safe and effective for treating ECIPAS.

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Section: Discussionmentioning

confidence: 57%

Laparoscopic Spleen-Preserving Distal Pancreatectomy for Epidermoid Cyst in An Intrapancreatic Accessory Spleen: A Case Report

Zheng

Zhou

Sun

et al. 2020

Preprint

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“…Including the present case, only 6 (10.7%) among the 56 reported cases were correctly diagnosed preoperatively [15,19–22] . Most cases of ECIPAS were diagnosed after surgery based on pathological findings [23] . Advances in imaging techniques facilitated the diagnosis of ECIPAS as compared with previously; however, few studies have reported the imaging characteristics of ECIPAS.…”

Section: Discussionmentioning

confidence: 67%

“…[15,[19][20][21][22] Most cases of ECIPAS were diagnosed after surgery based on pathological findings. [23] Advances in imaging techniques facilitated the diagnosis of ECIPAS as compared with previously; however, few studies have reported the imaging characteristics of ECIPAS. ECIPAS is a welldefined, unilocular, or multilocular cystic mass located in the tail of the pancreas on multimodality imaging.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic spleen-preserving distal pancreatectomy for epidermoid cyst in an intrapancreatic accessory spleen

et al. 2021

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Rationale: Pancreatic tail cystic lesions are increasingly encountered in clinical practice, however, it is difficult to make a correct diagnosis preoperatively because there are many types of pancreatic neoplastic and non-neoplastic cysts. Epidermoid cyst in an intrapancreatic accessory spleen (ECIPAS) is a rare non-neoplastic cyst locating in the pancreatic tail, and it is commonly misdiagnosed as another cystic neoplasm. Patient concerns: A 51-year-old man was admitted for investigation of abdominal pain. The physical examination and laboratory tests found no abnormalities, except for an elevation of carbohydrate antigen (CA)19-9. Imaging revealed a cystic lesion within the pancreatic tail, and the solid component surrounding the cyst was enhanced similarly to those of the splenic tissue. Diagnosis: ECIPAS was diagnosed based on the pathology after surgery. The mass was composed of a cyst and brown solid spleen-like tissue. The microscopic analysis demonstrated that the solid component was accessory splenic tissue, and the cyst wall was lined with a thin stratified squamous epithelium. Interventions: Laparoscopic spleen-preserving distal pancreatectomy was performed. Outcomes: The patient was discharged on day 5 postoperatively after an uneventful recovery. CA19-9 returned to normal after surgery. During a 2-years follow-up, there was no evidence of tumor recurrence. Lessons: Although rare ECIPAS should be considered in the differential diagnosis of pancreatic tail cystic lesions, and the typical imaging features might facilitate the preoperative diagnosis. Laparoscopic distal pancreatectomy is a safe and effective approach for treating ECIPAS.

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“…However, a cyst occurring in a pancreatic accessory spleen is extremely rare, with only 57 reported cases (Table 1). 8‐53 The lesion site was the pancreatic tail in all 57 cases. The primary complaints were abdominal pain and vomiting, although 33 of the 57 cases were asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

A lymphoepithelial cyst in the pancreatic accessory spleen: A case report

Hiroi

Hamaoka

Yamamoto

et al. 2021

Clinical Case Reports

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Laparoscopic spleen-preserving pancreatic resection for epidermoid cyst in an intrapancreatic accessory spleen: case report and literature review

Cited by 7 publications

References 38 publications

Laparoscopic Spleen-Preserving Distal Pancreatectomy for Epidermoid Cyst in An Intrapancreatic Accessory Spleen: A Case Report

Laparoscopic Spleen-Preserving Distal Pancreatectomy for Epidermoid Cyst in An Intrapancreatic Accessory Spleen: A Case Report

Laparoscopic spleen-preserving distal pancreatectomy for epidermoid cyst in an intrapancreatic accessory spleen

A lymphoepithelial cyst in the pancreatic accessory spleen: A case report

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