Unusual lesions of the pancreas: A case series and review of the literature

Lesions of the pancreas are commonly found, particularly with increased use of cross-sectional imaging. While there are a few well-described entities, atypical benign masses remain a diagnostic challenge and may mimic malignancy, leading to uncertainty in management. We present four cases of unusual, benign pancreatic lesions managed at a tertiary care center. While initially concerning for malignancy based on imaging and clinical presentation, these cases were ultimately diagnosed as a torsed ectopic splenule, lymphoepithelial cyst, benign simple mucinous cyst, and chronic mass-forming pancreatitis. Evaluation included imaging, endoscopic ultrasound, and tissue sampling. All patients underwent surgical resection, with final diagnoses confirmed through intraoperative findings and histopathology. A brief literature review was conducted for each entity to summarize distinguishing clinical, radiographic, and pathologic features. Further description of these atypical entities may help clinicians with appropriate diagnosis and guide treatment decisions.