RESUMO
There are few reports of intrapancreatic accessory spleen. Most cases have been reported in Japan and some refer epithelial cysts within it. Most of these lesions are asymptomatic and may be misdiagnosed as a non-functioning neuroendocrine tumor due to their radiological characteristics and lack of symptomatology. We report a case of a 46 year old woman with an incidentally diagnosed intrapancreatic accessory spleen. Because of a history of weight loss and a severe acanthosis nigricans a hidden neoplasia was sought. A 2.5 x 1 cm lesion was found in the tail of the pancreas on computed tomography scan and later confirmed with endoscopic ultrasound. A non-diagnostic biopsy was undertaken. A distal pancreatectomy with splenectomy was performed and a final pathological diagnosis of intrapancreatic accessory spleen was given. The 99mTc-denatured RBC scan in addition to the octreotide scintigraphy have been proposed to differentiate it from other intrapancreatic tumors and avoid unnecessary surgery. Intrapancreatic accessory spleen should be considered as a differential diagnosis for pancreatic tumors.