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Epidermoid cyst of the intrapancreatic accessory spleen producing CA19‐9
Author(s) -
Watanabe Hiroyuki,
Yamaguchi Yasushi,
Ohtsubo Koushiro,
Mouri Hisatsugu,
Motoo Yoshiharu,
Yamashita Kaname,
Minamoto Toshinari,
Gabata Toshifumi,
Sawabu Norio
Publication year - 2004
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2004.00347.x
Subject(s) - medicine , epidermoid cyst , ca19 9 , accessory spleen , cyst , pathology , pancreatic duct , carcinoembryonic antigen , pancreas , pancreatic cancer , differential diagnosis , lesion , endoscopic ultrasound , splenectomy , radiology , spleen , cancer
We report a rare case of an epidermoid cyst in an accessory spleen at the pancreatic tail with producing CA19‐9. A 55‐year‐old female was admitted to our hospital, Cancer Research Institute, Kanazawa University, for close examination of a cystic lesion at the pancreatic tail and a high serum CA19‐9‐value (176 U/mL). There were almost no abdominal symptoms related to the cystic lesion. A cystic tumor approximately 3 cm in diameter and composed of multilocular cysts without a protruding portion of the inner surface was found at the pancreatic tail by ultrasound sonography, computed tomography, and magnetic resonance imaging. Endoscopic retrograde pancreatography revealed that the main pancreatic duct shifted at the pancreatic tail and there was no communication between the main pancreatic duct and cystic lesion. Based on a preoperative diagnosis of mucinous cystic tumor, distal pancreatectomy with splenectomy was performed. Histological ndings suggested an epidermoid cyst (3.5 × 3.0 cm) originating from an intrapancreatic accessory spleen. Immunohistochemical analysis of CA19‐9 in the epidermoid cyst showed clear staining of the inner epithelium of the cyst and amorphous or hyalinous cystic contents. The serum CA19‐9 value was conrmed to decline to normal 2 months after resection. Physicians should not forget this disease during differential diagnosis related to pancreatic cystic lesions with elevated levels of serum tumor markers, such as CA19‐9 or carcinoembryonic antigen, although this disease is extremely rare.