Large Intrapancreatic Accessory Spleen Mimicking a Hypervascular Tumor of the Pancreatic Tail

Bazo accesorio intrapancreático grande que simula un tumor hipervascular en la cola del páncreas

Authors

  • Carlos Alfredo Iñiguez Guzmán Scanner Cuenca Corp. Cuenca, Ecuador.
  • Joel Sebastian Vintimilla Contreras Universidad Católica de Cuenca

DOI:

https://doi.org/10.22258/hgh.v10i2.440

Abstract

The intrapancreatic accessory spleen (IPAS) constitutes a major diagnostic challenge due to its ability to mimic hypervascular neoplasms in the pancreatic tail, primarily neuroendocrine tumors. Accurate identification is crucial to avoid major surgical interventions, such as distal pancreatectomy, for an incidental benign finding. We report the case of a 66-year-old male with non-specific abdominal pain and asthenia, in whom initial ultrasonography revealed a 6 cm solid mass in the pancreatic tail. Characterization through multiphase computed tomography (CT) identified a well-defined exophytic lesion with hemodynamic behavior identical to the splenic parenchyma across all study phases. Key findings included heterogeneous "zebra-like" enhancement during the arterial phase, followed by isodense homogenization in the venous and equilibrium phases, maintaining strict Hounsfield unit correlation relative to the spleen. Visualization of a feeding vessel derived from the splenic artery determined the diagnosis of IPAS, ruling out the initial suspicion of a neuroendocrine tumor. Recognition of these enhancement patterns and density stability are the cornerstones for non-invasive diagnosis, ensuring conservative management and optimizing surgical resource allocation for anatomical variants that do not require resection. Keywords: Splenosis; Pancreatic Neoplasms; Pancreas; Multidetector Computed Tomography (Source: MeSH, NLM).

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Author Biographies

Carlos Alfredo Iñiguez Guzmán, Scanner Cuenca Corp. Cuenca, Ecuador.

Scanner Cuenca Corp. Médico especialista en imagenología en Cuenca, Ecuador.

Joel Sebastian Vintimilla Contreras, Universidad Católica de Cuenca

Rotating Medical Intern at Hospital de Especialidades Eugenio Espejo, from Universidad Católica de Cuenca. Founder of the Medical Interns Research Committee of the Hospital de Especialidades Eugenio Espejo (CIM-HEE).

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Published

2026-06-15

How to Cite

Iñiguez Guzmán, C. A., & Vintimilla Contreras, J. S. (2026). Large Intrapancreatic Accessory Spleen Mimicking a Hypervascular Tumor of the Pancreatic Tail: Bazo accesorio intrapancreático grande que simula un tumor hipervascular en la cola del páncreas. Peruvian Journal of Health Care and Global Health, 10(2). https://doi.org/10.22258/hgh.v10i2.440

Issue

Vol. 10 No. 2 (2026)

Section

Case reports

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Copyright (c) 2026 Carlos Alfredo Iñiguez-Guzmán, Joel Sebastian Vintimilla-Contreras

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