Laparoscopic spleen-preserving pancreatic tail resection of an epidermoid cyst occurring within an intrapancreatic accessory spleen

Yusuke Kumamoto, MD, PhD, Hiroyuki Katagiri, MD, Takashi Kaitsu, MD, Hiroki Kamata, MD, Hiroshi Tajima, MD, Masahiko Watanabe, MD, PhD

Department of Surgery, KITASATO University School of Medicine

We report a rare case of an epidermoid cyst originating from intrapancreatic accessory spleen which was getting larger during one year-observation, and finally treated by laparoscopic operation. A 39-year-old male presented with complaints of abdominal pain. Imaging analysis revealed pancreatic cyst 20mm in diameter, surrounded by solid component as the same attenuation as the spleen, suspicious of epidermoid cyst originating from an accessory spleen in the pancreas. 1 year later, the cyst was getting larger to 36mm in diameter; solid component was getting thinner to minimum. The possibility of malignancy could not be rule out. We therefore performed a laparoscopic spleen-preserving pancreatic tail resection for both diagnostic and treatment purposes. The histo-pathological diagnosis was in agreement with the preoperative one. The postoperative course was uneventful and the patient was discharged on 9 post-operative days. This case demonstrates that an epidermoid cyst origination from intrapancreatic accessory spleen can show a rapid growth even if it is benign, and the laparoscopic spleen-preserving pancreatic tail resection can be a useful procedure at the point of less invasiveness and organ preservation for pancreatic tumors such as difficult to diagnose.

Session: Poster Presentation

Program Number: P369