Intrapancreatic accessory spleen; pancreatic glucagonoma

CASE SUMMARIES Case 1 was that of a 2 cm nodule fortuitously discovered by ultrasonography in the pancreatic tail of a 66-year-old man. The patient’s CA 19-9, CEA and Chromogranine A levels were all normal. Endoscopic ultrasonography confirmed the presence of the nodule in the pancreatic tail, but transgastric, fine-needle aspiration of the lesion could not establish a diagnosis. Case 2 was that of a 42-year-old woman with a history of multiple endocrine neoplasia type 1 syndrome (with heterozygous mutation of exon 10 on the MENIN gene), who was referred for long-lasting symptomatic hypoglycemia. A fasting test failed to reveal concomitant elevated values of serum insulin or C-peptide.