# Intra pancreatic accessory spleen mimicking pancreatic insulinoma: a case report

## TL;DR

A 61-year-old patient with hypoglycemia was found to have an accessory spleen in the pancreas, which was initially mistaken for a tumor.

## Contribution

This case report highlights the diagnostic challenge of distinguishing accessory spleens from pancreatic insulinomas.

## Key findings

- Accessory spleen in the pancreatic tail was misidentified as a neuroendocrine tumor due to arterial enhancement.
- The patient presented with recurrent hypoglycemia, leading to suspicion of an insulinoma.
- Imaging and clinical evaluation confirmed the presence of an accessory spleen rather than a tumor.

## Abstract

Accessory spleens are a congenital anomaly caused by abnormal fusion during embryonic development, leading to the presence of splenic tissue in unusual locations, such as the tail of the pancreas. Their pronounced arterial enhancement can cause them to be mistaken for a neuroendocrine tumor, particularly an insulinoma. We report the case of a 61-year-old patient with recurrent hypoglycemia who was referred for suspected neuroendocrine tumor.