An Unusual Presentation of a Solid Pseudopapillary Tumor of the Pancreas Mimicking Adenocarcinoma

Solid pseudopapillary neoplasm of the pancreas in an adolescent: A case report and review of the literature

BACKGROUND

Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare epithelial tumor that primarily affects young women. Since the condition is often asymptomatic or presents with non-specific symptoms, its diagnosis can be difficult.

CASE SUMMARY

This report details the case of a 15-year-old girl who presented with a 2-year history of abdominal pain, with no significant findings during physical examination. Abdominal ultrasound revealed a well-defined heterogeneous solid-cystic mass in the epigastric region, likely originating from the tail of the pancreas. A subsequent contrast-enhanced computed tomography scan indicated a well-defined cystic lesion with an enhancing solid component and capsule in the tail of the pancreas, suggestive of a cystic neoplasm. The patient underwent an open distal pancreatectomy with splenectomy, and histopathological analysis confirmed the diagnosis of SPN of the pancreas.

CONCLUSION

This case highlights the risk of SPN in adolescent girls and the necessity of early diagnosis and intervention for better outcomes.

Rare case of solid pseudopapillary neoplasm of the pancreas with liver and splenic metastasis in a 19-year-old girl

INTRODUCTION

Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare neoplasms, accounting for only 1 %-2 % of all pancreatic tumors, and predominantly affect female patients.

CASE PRESENTATION

The present case report details a patient presenting to the emergency department with abdominal pain for 3 days who ultimately received a diagnosis of SPNs in the pancreatic body and tail. A contrast-enhanced computed tomography (CT) scan revealed a sizable mass arising from the pancreas, featuring an enhancing cystic component with involvement of the liver and spleen. The patient underwent subsequent exploratory laparotomy, a distal pancreatectomy, splenectomy, and partial hepatectomy. SPN diagnosis was confirmed by histopathology and immunohistochemistry with negative resection margins.

CLINICAL DISCUSSION

Approximately 70 % of SPN cases are asymptomatic and are incidentally discovered. Despite advances in diagnostic modalities, preoperative diagnosis of SPNs remains a clinical challenge. Surgical management with negative resection margins remains the primary treatment approach. The recurrence rate after surgical resection has been reported to be 3 %-9 %. The prognosis for SPNs limited to the pancreas is generally favorable, with a cure rate exceeding 95 % after complete surgical resection.

CONCLUSION

An SPN of the pancreas is a rare tumor observed in young female patients. Although it is classified as a malignant tumor, SPN has low malignant potential. Aggressive surgical resection, however, has proven effective in curing SPN for the majority of patients.

Large Solid Pseudopapillary Tumor Pancreas with Extensive Splenoportal Thrombosis and Malignant Transformation—A Rare Entity

Solid pseudopapillary tumor (SPT) is an uncommon low-grade malignant cystic exocrine neoplasm of the pancreas that typically affects young women. The tumor has an excellent prognosis after surgical resection. Vascular involvement is usually not seen at presentation. Local recurrence and metastasis are also rare. Herein, we present a case of large, locally advanced SPT in a young female with splenoportal extension and malignant transformation.

Huge solid pseudopapillary tumor of the pancreas 'Frantz tumor': a case report

Solid pseudopapillary neoplasms (SPN) of the pancreas are rare neoplasms accounting for 1-2% of all pancreatic tumors and have a general female predominance. We report a case and intraoperative videos of SPN involving the whole pancreatic tail. A 19-year-old female patient initially presented to another healthcare facility complaining of abdominal pain, which was started 6 years ago. A contrast-enhanced Computed Tomography (CT) scan of the abdomen showed a large mass measuring 15.6 cm × 11.6 cm × 11 cm, arising from the pancreas with an enhancing cystic component. The patient underwent exploratory laparotomy, which revealed a huge mass occupying most of the abdominal cavity. Thus, we proceeded with a distal pancreatectomy and splenectomy. Intraoperatively, the frozen section showed that the mass had features of a solid pseudopapillary tumor of the pancreas with negative resection margins. The SPN diagnosis was confirmed by histopathology and immunohistochemistry. The pathophysiology behind the development of SPN and its cellular origin is still a matter of debate with multiple proposed hypotheses. SPNs are asymptomatic in almost 70% of all cases and usually discovered incidentally. The pre-operative diagnosis of SPNs remains a clinical challenge despite all the current advances in the diagnostic modalities. Surgical management with negative resection margins is the mainstay of treatment, even with metastasis and vascular invasion, surgical excision should be performed whenever feasible. The recurrence rate after surgical resection has been reported to be 3-9%. The prognosis of SPN limited to the pancreas is generally excellent with over 95% cure rate following complete surgical resection. SPN is a rare entity of a controversial origin but is considered as a low-grade malignancy. Surgical resection to achieve complete excision constitutes the mainstay of treatment, which mostly results in an excellent prognosis.