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Laparoscopic Resection of an Epidermoid Cyst Arising from Intrapancreatic Accessary Spleen

Context An epidermoid cyst arising from intrapancreatic accessory spleen is rare. Herein, we report the patient who had an epidermoid cyst arising from intrapancreatic accessory spleen with typical imaging features, which was diagnosed by preoperative imaging studies and successfully treated with minimally invasive surgery. Case report A seventy-five-year-old male was referred to our hospital presenting with left upper abdominal pain. Multidetector computed tomography highlighted a large cystic lesion with a diameter of 7 cm in the tail of the pancreas. Although the cystic components were low density and remained unenhanced during multiphase scans, a contrast enhancement pattern of the cystic walls was similar to that of the spleen on each phase. This patient was diagnosed with epidermoid cyst arising from intrapancreatic accessory spleen and underwent laparoscopic distal pancreatectomy and splenectomy to achieve painrelief. The final pathological diagnosis was an epidermoid cyst arising from intrapancreatic accessory spleen. Postoperative course was uneventful, and his chief complaint completely resolved after surgery. Conclusion With recent advances of dynamic contrast imaging, the diagnosis of epidermoid cyst arising from intrapancreatic accessory spleen may be possible. In order to avoid unnecessary surgery, precise work-up and reliable preoperative diagnosis is necessary. When surgical resection is necessary to improve patient’s symptoms, less invasive surgery with laparoscopic resection would be preferable.


Masato Narita, Keita Hanada, Koki Moriyoshi, Ryo Matsusue, Hiroaki Hata, Takashi Yamaguchi, Tetsushi Otani, Iwao Ikai

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