Intra-pancreatic Accessory Spleen Mimicking Pancreatic Neuroendocrine Tumor on 68-Ga-Dotatate PET/CT

Neuroendocrine tumors (NETs) are rare tumors, but the incidence is increasing with new diagnostics. A 37-year-old man was admitted to our hospital for an incidental 17-mm nodule in the tail of the pancreas. PET/CT shows indeterminate mass in the pancreatic tail with enhanced uptake of 68-Ga-DOTATATE. NET was suspected and laparoscopic distal pancreatectomy was performed. Pathologic examination revealed an accessory spleen with a heterotopic location. To the best of our knowledge, this is the first IPAS case in which the positive 68-Ga-DOTATATE uptake reported in the literature. Our case showed that IPAS is one of the reasons of false positive involvement of 68-Ga-DOTATATE PET/CT. When PET/CT shows an indeterminate mass in the pancreatic tail with enhanced uptake of 68-Ga-DOTATATE, surgeons should keep IPAS in their mind for differential diagnosis to avoid false treatment.