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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Main Authors: Chong-yuan Chen, Yu Yang, Ming-zheng Hu, Rong-chun Xing
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
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.
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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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