Epidermoid Cyst Mimicking Mucinous Cystic Neoplasm

Epidermoid cyst in an intrapancreatic accessory spleen is rare benign cyst and characterized by
non-neoplastic keratinizing epithelium surrounded by splenic parenchyma [1]. A previous study reported that about 52% of the patients present the elevated CA19-9 levels [2]. The presence of keratinization and the absence of a lymphoid component allows epidermoid cyst to be differentiated from
other lesions containing squamous epithelium, including dermoid cysts and lymphoepithelial cysts.
For diagnosing epidermoid cyst of the pancreas, detecting a component of spleen by imaging modalities such as super-paramagnetic iron oxide-enhanced magnetic resonance imaging is important for
avoiding unnecessary operation. The suspicion of epidermoid cyst should be raised if when encountering a patient with a cystic lesion in the tail of the pancreas and elevated CA19-9 levels