Introduction: An accessory spleen (splenunculus) may occur in up to 10% of the general population. However, an epithelial inclusion cyst originating within an intra-pancreatic splenunculus is an extremely rare finding, with only twenty-two previous cases described in medical literature.
Presentation of case: A 51-year-old male presented to our institution for investigation of altered bowel habit. Endoscopic ultrasound examination and CT scanning demonstrated an 18 mm cystic, well-demarcated lesion in the tail of the pancreas, resembling malignancy. Following laparoscopic spleen-preserving distal pancreatectomy, histological analysis confirmed epithelial inclusion cyst arising within an intra-pancreatic splenunculus.
Discussion: The pre-operative radiological identification of such cystic pancreatic lesions is challenging. Surgical resection is usually performed for clinical suspicion of pancreatic malignancy.
Conclusion: Epithelial inclusion cyst originating within an intra-pancreatic accessory spleen is an extremely rare finding, which can mimic malignancy. Nevertheless, it should be carefully considered in the differential diagnosis of cystic lesions of the tail of the pancreas.
Keywords: Cyst; Epidermoid; Epithelial; Pancreas; Spleen; Splenunculus.