Distal pancreatectomy with splenectomy for a large pancreatic lymphoepithelial cyst: a case report and review of the literature.

BACKGROUND

Pancreatic lymphoepithelial cyst is a rare benign pancreatic lesion with challenging preoperative diagnosis due to its radiological similarity to other cystic pancreatic diseases. Definitive diagnosis typically relies on histopathological examination after surgical excision. We present a case of pancreatic lymphoepithelial cyst and review 21 patients who underwent surgical treatment for pancreatic lymphoepithelial cyst from 2016 to 2024, aiming to enhance the diagnostic and therapeutic management of this disease.

CASE PRESENTATION: A 66-year-old Asian male from China was admitted to the hospital owing to left upper abdominal pain and bloating for 3 months. Imaging revealed a 7.5-cm cystic mass in the pancreatic tail, closely associated with the splenic vessels. The patient underwent a distal pancreatectomy with splenectomy. Postoperative pathology confirmed pancreatic lymphoepithelial cyst. The patient recovered uneventfully and remained symptom-free during a 1-month follow-up.

CONCLUSION

Although rare and of uncertain origin, pancreatic lymphoepithelial cyst should be considered in the differential diagnosis of pancreatic cystic lesions. Imaging combined with endoscopic ultrasound-guided fine needle aspiration may aid in diagnosis, and management strategies should be tailored to individual cases.