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Intrapancreatic Accessory Spleen: A Differential Diagnosis to Neuroendocrine Tumors of the Pancreas on Ga-68-DOTATOC PET/CT

Isabelle Fülber, Christoph Wurster, Damiano Librizzi, Marion Rößler, Eike Gallmeier, Detlef K Bartsch

A Seventy-three-year-old Caucasian woman underwent a contrast-enhanced computed tomography to clarify a deep venous thrombosis because of a swollen left leg. The CT revealed a contrast-enhancing 18x20 mm sized lesion in the pancreatic tail. It was suspected to be a neuroendocrine tumor and a Ga-68-DOTATOC-PET/CT showed a corresponding strong focal uptake. Laparoscopic spleen-preserving distal pancreatectomy was performed and histopathological examination diagnosed an intrapancreatic accessory spleen. The presence of IPAS should be kept in mind even in case of positive Ga-68-DOTATOC-PET/CT imaging to avoid unnecessary pancreatic resections.