Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2020; 8(9): 1729-1734
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1729
Endoscopic ultrasonography elastography in the diagnosis of intrapancreatic ectopic spleen: A case report
Nan Ge, Si-Yu Sun
Nan Ge, Si-Yu Sun, Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Ge N and Sun SY contributed to study planning and manuscript drafting.
Supported by Natural Science Fund of Liaoning Province, No. 20180530014.
Informed consent statement: Informed written consent was obtained from the relatives of the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: Si-Yu Sun, MD, PhD, Chief Doctor, Director, Professor, Department of Gastroenterology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, Liaoning Province, China. sunsy@sj-hospital.org
Received: December 22, 2019
Peer-review started: December 23, 2019
First decision: February 20, 2020
Revised: March 15, 2020
Accepted: April 10, 2020
Article in press: April 10, 2020
Published online: May 6, 2020
Processing time: 130 Days and 3.8 Hours
Abstract
BACKGROUND

Intrapancreatic accessory spleen (IPAS) mimics a pancreatic neoplasm on imaging studies, and due to the lack of radiological diagnostic criteria, patients undergo unnecessary distal pancreatectomies. Endoscopic ultrasonography (EUS) is a reliable and efficient diagnostic modality for pancreatic diseases. However, no EUS criteria have been established for IPAS. We present the EUS-elastography image of IPAS, which may minimize the chance of misdiagnosis in the future.

CASE SUMMARY

A 50-year-old man was referred for an EUS evaluation after computed tomography showed a hypervascular enhanced mass in the tail of the pancreas, which indicated a neuroendocrine neoplasm. EUS elastography demonstrated that the lesion of interest covered no more than 25% of the region of interest. The patient underwent distal pancreatectomy. However, the resected tissue was evaluated, and the patient was finally diagnosed with IPAS.

CONCLUSION

IPAS should be considered in patients with suspected pancreatic neuroendocrine tumors of the pancreatic tail before surgery is performed. The differentiation between IPAS and pancreatic neuroendocrine tumors can be demonstrated using EUS-elastography.

Keywords: Intrapancreatic accessory spleen; Endoscopic ultrasonography; Elastography; Case report

Core tip: We report the case of a patient with intrapancreatic accessory spleen evaluated by endoscopic ultrasonography and endoscopic ultrasonography elastography. We present the endoscopic ultrasound-elastography features of intrapancreatic accessory spleen, which may help to minimize the chance of misdiagnosis and prevent patients from undergoing unnecessary surgery in the future.