Incidentally discovered pancreatic cysts have become more common with increasing use of abdominal cross-sectional imaging.Tools that help us to better risk stratify a pancreatic cyst include advanced imaging techniques, such as pancreatic sign protocol computed tomography (CT) scan or magnetic resonance imaging (MRI) with cholangiopancreatography.Endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) are invasive measures to better define and sample cysts especially if high-risk features are present.
EUS may also yield pancreatic cyst fluid for analysis of carcinoembryonic antigen (CEA) which is elevated in mucinous cysts.This case highlights a rare finding of a mucinous, epidermoid cyst in LED Lamp an intrapancreatic accessory spleen (IPAS) with high-risk features on EUS.