EC Gastroenterology and Digestive System

Intrapancreatic accessory spleens (IPAS), a rare congenital anomaly that can often be misdiagnosed as pancreatic tumors. IPAS are usually asymptomatic and incidentally discovered, but can present as well-defined hyperechoic lesions on endoscopic ultrasound imaging (EUS), leading to misdiagnosis. Accurate diagnosis of IPAS is crucial to avoid unnecessary surgeries and associated risks. This article reviews the imaging modalities used to differentiate IPAS from pancreatic tumors, including EUS, CT, MRI, and nuclear medicine. The study concludes that the use of DWI and ADC maps in conjunction with conventional MRI sequences before and after injection of gadolinium can improve the accuracy of IPAS diagnosis. Nuclear medicine, including 99Tcm-SC and 99Tcm-HDRBC scintigraphy, can also be used to distinguish IPAS from other tumors. A multidisciplinary approach, combining CT, MRI, and nuclear medicine, is essential to avoid unnecessary surgeries and associated risks.

Keywords: IPAS; NET; MRI; Differential Diagnosis

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