Radiologic Findings of Pancreatic Cystic Neoplasms / 대한내과학회지

With the widespread use of radiologic modalities such as ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), cystic neoplasms of the pancreas are being increasingly detected; however, developing an accurate characterization and making a differential diagnosis are difficult because of their overlapping morphologic characteristics. Serous cyst adenoma is a common benign neoplasm that is typically observed as a multi-cystic mass or lobulated cyst with or without internal septation. In comparison, mucinous cystic neoplasms appear as smooth cystic tumors with or without internal septation. Finally, intraductal papillary mucinous neoplasms of the pancreas are pleomorphic cystic lesions or clubbed fingerlike tubular structures. These typical imaging findings can help clinicians differentiate cystic neoplasms of the pancreas.

A Case of Epidermoid Cyst in the Intrapancreatic Accessory Spleen Mimicking Pancreas Mucinous Cystic Neoplasm / 대한췌담도학회지

An epidermoid cyst arising from intrapancreatic accessory spleen (ECIPAS) is a rare disease. Most patients with an ECIPAS are detected incidentally and could be misdiagnosed as a pancreatic cystic neoplasm such as mucinous cystic neoplasm (MCN) or intraductal p ancreatic mucinous neoplasm (IPMN). We described an ECIPAS with high cystic fluid carcinoembryonic antigen (CEA), which was misdiagnosed as a MCN of pancreas. Fifty one-year-old female was presented with a 2 cm sized non-enhancing pancreas cystic mass on the outside CT scan. Endoscpic ultrasonography (EUS) guided aspiration was performed. It showed a 2.3 x 1.9 cm unilocular cyst nearby 1.6 x 1.1 cm homogenous hypoechoic mass in pancreas tail, and cystic fluid CEA was 1564.18 ng/mL. On the basis of EUS results with elevated fluid CEA level, the presumptive diagnosis is likely to MCN of pancreas, and she underwent a laparoscopic distal pancreatectomy. The final pathology was the epidermal cyst in the intrapancreatic accessory spleen.