Case Report: A rare case of hemorrhagic cystic IPAS masquerading as pancreatic neoplasm
Intrapancreatic accessory spleen (IPAS) is a rare congenital developmental anomaly that is typically benign and does not require specific treatment. However, when IPAS undergoes hemorrhage and subsequent cystic degeneration, its clinical symptoms and laboratory findings often lack specificity, and i...
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| Language: | English |
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1626836/full |
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| author | Chong-yuan Chen Chong-yuan Chen Yu Yang Yu Yang Ming-zheng Hu Ming-zheng Hu Rong-chun Xing Rong-chun Xing |
| author_facet | Chong-yuan Chen Chong-yuan Chen Yu Yang Yu Yang Ming-zheng Hu Ming-zheng Hu Rong-chun Xing Rong-chun Xing |
| author_sort | Chong-yuan Chen |
| collection | DOAJ |
| description | Intrapancreatic accessory spleen (IPAS) is a rare congenital developmental anomaly that is typically benign and does not require specific treatment. However, when IPAS undergoes hemorrhage and subsequent cystic degeneration, its clinical symptoms and laboratory findings often lack specificity, and imaging studies can be misleading, frequently resulting in misdiagnosis as pancreatic tumors or other lesions. This poses significant challenges for preoperative diagnosis. We report a case of a 53-year-old woman presenting with vague upper abdominal pain. Preoperative imaging strongly suggested a mucinous cystic neoplasm of the pancreas. However, postoperative pathology following laparoscopic distal pancreatectomy combined with splenectomy confirmed hemorrhagic cystic degeneration of an IPAS. This case highlights the importance of considering hemorrhagic cystic IPAS in the differential diagnosis of pancreatic space-occupying lesions, particularly when imaging findings are atypical or inconclusive. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a safe and effective method for obtaining a pathological diagnosis. Enhanced awareness of this condition, combined with meticulous radiological evaluation and necessary histopathological biopsy, can reduce misdiagnosis, avoid unnecessary surgical trauma, and improve individualized treatment strategies. |
| format | Article |
| id | doaj-art-8d7c74198cfc45a1ae4ab2f61a478f53 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-8d7c74198cfc45a1ae4ab2f61a478f532025-08-20T03:28:26ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.16268361626836Case Report: A rare case of hemorrhagic cystic IPAS masquerading as pancreatic neoplasmChong-yuan Chen0Chong-yuan Chen1Yu Yang2Yu Yang3Ming-zheng Hu4Ming-zheng Hu5Rong-chun Xing6Rong-chun Xing7The First College of Clinical Medical Science, China Three Gorges University, Hubei Yichang, ChinaDepartment of Hepatobiliary Surgery, Yichang Central People’s Hospital, Hubei, ChinaThe First College of Clinical Medical Science, China Three Gorges University, Hubei Yichang, ChinaDepartment of Hepatobiliary Surgery, Yichang Central People’s Hospital, Hubei, ChinaThe First College of Clinical Medical Science, China Three Gorges University, Hubei Yichang, ChinaDepartment of Hepatobiliary Surgery, Yichang Central People’s Hospital, Hubei, ChinaThe First College of Clinical Medical Science, China Three Gorges University, Hubei Yichang, ChinaDepartment of Hepatobiliary Surgery, Yichang Central People’s Hospital, Hubei, ChinaIntrapancreatic accessory spleen (IPAS) is a rare congenital developmental anomaly that is typically benign and does not require specific treatment. However, when IPAS undergoes hemorrhage and subsequent cystic degeneration, its clinical symptoms and laboratory findings often lack specificity, and imaging studies can be misleading, frequently resulting in misdiagnosis as pancreatic tumors or other lesions. This poses significant challenges for preoperative diagnosis. We report a case of a 53-year-old woman presenting with vague upper abdominal pain. Preoperative imaging strongly suggested a mucinous cystic neoplasm of the pancreas. However, postoperative pathology following laparoscopic distal pancreatectomy combined with splenectomy confirmed hemorrhagic cystic degeneration of an IPAS. This case highlights the importance of considering hemorrhagic cystic IPAS in the differential diagnosis of pancreatic space-occupying lesions, particularly when imaging findings are atypical or inconclusive. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a safe and effective method for obtaining a pathological diagnosis. Enhanced awareness of this condition, combined with meticulous radiological evaluation and necessary histopathological biopsy, can reduce misdiagnosis, avoid unnecessary surgical trauma, and improve individualized treatment strategies.https://www.frontiersin.org/articles/10.3389/fonc.2025.1626836/fullIntrapancreatic accessory spleenhemorrhagic cystic degenerationpancreatic neoplasmmucinous cystic neoplasmdifferential diagnosislaparoscopic distal pancreatectomy |
| spellingShingle | Chong-yuan Chen Chong-yuan Chen Yu Yang Yu Yang Ming-zheng Hu Ming-zheng Hu Rong-chun Xing Rong-chun Xing Case Report: A rare case of hemorrhagic cystic IPAS masquerading as pancreatic neoplasm Frontiers in Oncology Intrapancreatic accessory spleen hemorrhagic cystic degeneration pancreatic neoplasm mucinous cystic neoplasm differential diagnosis laparoscopic distal pancreatectomy |
| title | Case Report: A rare case of hemorrhagic cystic IPAS masquerading as pancreatic neoplasm |
| title_full | Case Report: A rare case of hemorrhagic cystic IPAS masquerading as pancreatic neoplasm |
| title_fullStr | Case Report: A rare case of hemorrhagic cystic IPAS masquerading as pancreatic neoplasm |
| title_full_unstemmed | Case Report: A rare case of hemorrhagic cystic IPAS masquerading as pancreatic neoplasm |
| title_short | Case Report: A rare case of hemorrhagic cystic IPAS masquerading as pancreatic neoplasm |
| title_sort | case report a rare case of hemorrhagic cystic ipas masquerading as pancreatic neoplasm |
| topic | Intrapancreatic accessory spleen hemorrhagic cystic degeneration pancreatic neoplasm mucinous cystic neoplasm differential diagnosis laparoscopic distal pancreatectomy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1626836/full |
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