Intrapancreatic accessory spleen: An imaging enigma

The pancreatic tail is an uncommon location for the accessory spleen. Although it is a benign entity, it can mimic and get misdiagnosed as a pancreatic tumor which can lead to unnecessary biopsy and surgery. Here, we present a case who was detected to have a tail of pancreas mass. On CT and MRI, it showed similar density, signal intensity, and matching enhancement pattern with the orthotopic spleen. The ADC value of the mass was found to be similar to that of the spleen and significantly less than that of normal pancreas. A diagnosis of intrapancreatic accessory spleen was hence made and the patient was followed up after 6 months on MRI. No change in lesion morphology and size was noted. Thus, intrapancreatic accessory spleen should be kept in mind as a differential diagnosis while reviewing a case with pancreatic mass.