Huang JY, Yang R, Li JW, Lu Q, Luo Y. Cavernous hemangioma of an intrapancreatic accessory spleen mimicking a pancreatic tumor: A case report. World J Clin Cases 2022; 10(6): 1973-1980 [PMID: 35317146 DOI: 10.12998/wjcc.v10.i6.1973]
Corresponding Author of This Article
Yan Luo, MD, Full Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. luoyan15957@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 26, 2022; 10(6): 1973-1980 Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1973
Cavernous hemangioma of an intrapancreatic accessory spleen mimicking a pancreatic tumor: A case report
Jia-Yan Huang, Rui Yang, Jia-Wu Li, Qiang Lu, Yan Luo
Jia-Yan Huang, Rui Yang, Jia-Wu Li, Qiang Lu, Yan Luo, Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Luo Y performed the contrast-enhanced ultrasound examination for the patient and proposed writing it up as a case report; Huang JY collected the clinical information of the patient, reviewed the literature and contributed to manuscript drafting; Yang R provided the pathological data and helped with creating the figures; Li JW contributed to revising the grammar of the manuscript; Luo Y and Lu Q were responsible for the revision of the manuscript for important intellectual content; all of the authors issued final approval for this version of the manuscript to be submitted.
Supported bythe National Natural Science Foundation of China, No. 81571697.
Informed consent statement: Informed consent was obtained from the patient for the publication of any potentially identifiable images or data included in this article.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Luo, MD, Full Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. luoyan15957@126.com
Received: August 25, 2021 Peer-review started: August 25, 2021 First decision: October 27, 2021 Revised: November 2, 2021 Accepted: January 11, 2022 Article in press: January 11, 2022 Published online: February 26, 2022 Processing time: 182 Days and 3.8 Hours
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.
Core Tip: Intrapancreatic accessory spleen (IPAS) is an uncommon condition; however, overlapping imaging manifestations of IPAS and pancreatic tumors may lead to unnecessary surgery. Cystic splenic cavernous hemangioma is a rare disorder, whereas lesions with a cystic appearance arising from IPAS have not been reported. Herein, we report a cavernous hemangioma in the IPAS that was misdiagnosed as being a pancreatic cystadenoma via contrast-enhanced modalities. The diagnosis of cystic lesions in IPAS can be challenging. Imaging follow-ups or surgical interventions may be needed for the possible malignancy risk of a complicated cystic lesion, especially those with parietal and septal enhancements.
