Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy
Epithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is exceedingly rare with only 57 cases reported since the first publication in 1980. Comprehensive clinical and diagnostic features remain to be clarified. We present a case of ECIPAS in a 21-year-old Philippine woman who was admitted w...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/9475897 |
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| author | Willemijn P. M. van Dijck Vincent P. Groot Lodewijk A. A. Brosens Jeroen Hagendoorn Inne H. M. Borel Rinkes Maarten S. van Leeuwen I. Quintus Molenaar |
| author_facet | Willemijn P. M. van Dijck Vincent P. Groot Lodewijk A. A. Brosens Jeroen Hagendoorn Inne H. M. Borel Rinkes Maarten S. van Leeuwen I. Quintus Molenaar |
| author_sort | Willemijn P. M. van Dijck |
| collection | DOAJ |
| description | Epithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is exceedingly rare with only 57 cases reported since the first publication in 1980. Comprehensive clinical and diagnostic features remain to be clarified. We present a case of ECIPAS in a 21-year-old Philippine woman who was admitted with right upper quadrant abdominal pain. A cystic lesion in the pancreatic tail was discovered and evaluated by computed tomography and magnetic resonance images. Based on clinical and radiological features a solid pseudopapillary neoplasm was suspected. The patient underwent robot-assisted spleen preserving distal pancreatectomy. Pathological evaluation revealed a 26 mm intrapancreatic accessory spleen with a 16 mm cyst, lined by multilayered epithelium in the tail of the pancreas. The postoperative course was uneventful. Differentiating ECIPAS from (pre)malignant cystic pancreatic neoplasms based on clinical and radiological features remains difficult. When typical radiological signs can be combined with scintigraphy using Technetium-99m labelled colloid or Technetium-99m labelled erythrocytes, which can identify the solid component of the lesion as splenic tissue, it should be possible to make the right diagnosis noninvasively. When pancreatectomy is inevitable due to symptoms or patient preference, minimally invasive laparoscopic or robot-assisted spleen preserving distal pancreatectomy should be considered. |
| format | Article |
| id | doaj-art-d8b99f73b506428a87c21b6ce63a25a5 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-d8b99f73b506428a87c21b6ce63a25a52025-02-03T01:09:04ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362016-01-01201610.1155/2016/94758979475897Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal PancreatectomyWillemijn P. M. van Dijck0Vincent P. Groot1Lodewijk A. A. Brosens2Jeroen Hagendoorn3Inne H. M. Borel Rinkes4Maarten S. van Leeuwen5I. Quintus Molenaar6Department of Surgery, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Surgery, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Pathology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Surgery, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Surgery, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Radiology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Surgery, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, NetherlandsEpithelial cyst in an intrapancreatic accessory spleen (ECIPAS) is exceedingly rare with only 57 cases reported since the first publication in 1980. Comprehensive clinical and diagnostic features remain to be clarified. We present a case of ECIPAS in a 21-year-old Philippine woman who was admitted with right upper quadrant abdominal pain. A cystic lesion in the pancreatic tail was discovered and evaluated by computed tomography and magnetic resonance images. Based on clinical and radiological features a solid pseudopapillary neoplasm was suspected. The patient underwent robot-assisted spleen preserving distal pancreatectomy. Pathological evaluation revealed a 26 mm intrapancreatic accessory spleen with a 16 mm cyst, lined by multilayered epithelium in the tail of the pancreas. The postoperative course was uneventful. Differentiating ECIPAS from (pre)malignant cystic pancreatic neoplasms based on clinical and radiological features remains difficult. When typical radiological signs can be combined with scintigraphy using Technetium-99m labelled colloid or Technetium-99m labelled erythrocytes, which can identify the solid component of the lesion as splenic tissue, it should be possible to make the right diagnosis noninvasively. When pancreatectomy is inevitable due to symptoms or patient preference, minimally invasive laparoscopic or robot-assisted spleen preserving distal pancreatectomy should be considered.http://dx.doi.org/10.1155/2016/9475897 |
| spellingShingle | Willemijn P. M. van Dijck Vincent P. Groot Lodewijk A. A. Brosens Jeroen Hagendoorn Inne H. M. Borel Rinkes Maarten S. van Leeuwen I. Quintus Molenaar Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy Case Reports in Gastrointestinal Medicine |
| title | Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy |
| title_full | Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy |
| title_fullStr | Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy |
| title_full_unstemmed | Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy |
| title_short | Rare Case of an Epithelial Cyst in an Intrapancreatic Accessory Spleen Treated by Robot-Assisted Spleen Preserving Distal Pancreatectomy |
| title_sort | rare case of an epithelial cyst in an intrapancreatic accessory spleen treated by robot assisted spleen preserving distal pancreatectomy |
| url | http://dx.doi.org/10.1155/2016/9475897 |
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