Solid-Pseudopapillary tumor of the pancreas: Clinical and radiological features. Case report and review of the literature

Abstract

Solid-Pseudopapillary Tumor (SPT) of the pancreas is considered to be a rare pancreatic tumor that occurs in young females. Most SPTs are considered to be benign. However, the natural course of history has not yet been clarified. We reported a case of 25-year-old women with a patent history of splenectomy for hemolytic anemia, who presented intermittent abdominal pain and vomiting of 6 months ago. Physical examination revealed a hard mass of 8 × 5 cm in the left upper quadrant of the abdomen. Routine laboratory tests were within the normal range. CT-Scan showed an 8 × 6 cm lesion with irregular low density in the body and the tail of the pancreas. MRI showed a mass of 8 cm, surrounded by a capsule, with the irregular intensity both in T1 and T2 enhanced-images. Distal pancreatictomy was done as a definitive treatment via a Bi sub costal incision. Histopathological examination confirmed the diagnosis of SPT. There was no vascular invasion or other malignant features. The resection margins are free of lesions. The post operative course was uneventful. During post operative follow-up of 24 months, there is no sign of recurrence on CT-scan. SPT is a rare condition with a low potential for malignancy and favorable prognosis. Surgical resection is generally curative. Characteristic CT and MRI scans combined with age and sex profile should be sufficient for the diagnosis and the decision to operate.

Share and Cite:

Jarboui, S. , Daghfous, A. , Kacem, K. and Marhoul, L. (2013) Solid-Pseudopapillary tumor of the pancreas: Clinical and radiological features. Case report and review of the literature. Case Reports in Clinical Medicine, 2, 415-421. doi: 10.4236/crcm.2013.27110.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Chen, S.-Q., Zou, S.-S., Dai, Q.-B., et al. (2008) Clinical analysis of solid-pseudopap illary tumor of the pancreas: Report of 15 cases. Hepatobiliary & Pancreatic Diseases International, 7, 196-200.
[2] Arkuszewski, P., Pasieka, Z., Srebrzynski, A., et al. (2011) Solid pseudopapillary tumor of the pancreas in a young woman-case report. Polski Przeglad Chirurgiczny, 83, 389-391. http://dx.doi.org/10.2478/v10035-011-0062-0
[3] Kloppel, G., Morohoshi, T., John, H.D., et al. (1981) Solid and cystic acinar cell tumor of the pancreas. A tumor in young women with favorable prognosis. Virchows Archiv. A, Pathological Anatomy and Histology, 392, 171-183. http://dx.doi.org/10.1007/BF00430819
[4] Kloppel, G., Solcia, E., Longnecker, D.S., et al. (1996) Histological typing of tumors of the exocrine pancreas. In: World Health Organisation, Ed., International Histological Classification of Tumors, 2nd Edition, Springer, Berlin Heidelberg New York, 120-128.
[5] Lam, K.Y., Lo, C.Y. and Fan, S.T. (1999) Pancreatic solidcystic-pseudopapillary tumor: Clinicopathologic features in eight patients from Hong Kong and review of the literature. World Journal of Surgery, 10, 1045-1050.
http://dx.doi.org/10.1007/s002689900621
[6] Nakahara, K., Kobayashi, G., Fujita, N., et al. (2008) Solid-pseudopapillary tumor of the pancreas showing a remarkable reduction in size over the 10-year follow-up. Internal Medicine, 47, 1335-1339.
http://dx.doi.org/10.2169/internalmedicine.47.0767
[7] Shaikh, S., Arya, S., Ramadwar, M., et al. (2008) Three Cases of unusual solid-pseudopapillary tumors. Can radiology and histology aid decision-making. JOP, 9, 150-159.
[8] Tang, L.H., Aydin, H., Brennan, M.F., et al. (2005) Clinically aggressive solid-pseudopapillary tumors of the pancreas: A report of two cases with components of undifferentiated carcinoma and a comparative clinicopathologic analysis of 34 conventional cases. The American Journal of Surgical Pathology, 29, 512-519.
http://dx.doi.org/10.1097/01.pas.0000155159.28530.88
[9] Nishihara, K., Nagoshi, M., Tsuneyoshi, M., et al. (1993) Papillary cystic tumors of the pancreas, assessment of their malignant potential. Cancer, 71, 82-92.
http://dx.doi.org/10.1002/1097-0142(19930101)71:1<82::AID-CNCR2820710114>3.0.CO;2-Y
[10] Kang, C.M., Kim, K.S., Choi, J.S., et al. (2006) Solidpseudopapillary tumor of the pancreas suggesting malignnant potential. Pancreas, 3, 276-280.
http://dx.doi.org/10.1097/01.mpa.0000202956.41106.8a
[11] Mulkeen Abby, L., Yoo Peter, S. and Cha, C.H. (2006) Less common neoplasm of the pancreas. World Journal of Gastroenterology, 12, 3180-3185.
[12] Yu, P.F., Hu, Z.H., Wang, X.B., et al. (2010) Solid pseudopapillary tumor of the pancreas: A review of 553 cases in Chinese literature. World Journal of Gastroenterology, 16, 1209-1214.
http://dx.doi.org/10.3748/wjg.v16.i10.1209
[13] Khan, F.Y., El-Hiday, A. and Morad, N.A. (2007) Plummer-vinson syndrome associated with solid-pseudopapillary tumor of the pancreas. Chinese Medical Journal, 120, 1553-1555.
[14] Cheuk, W., Beavon, I., Chui, D.T., et al. (2011) Extrapancreatic solid pseudopapillary neoplasm: Report of a case of primary ovrian origin and review of the literature. International Journal of Gynecologic Pathology, 30, 539-543. http://dx.doi.org/10.1097/PGP.0b013e31821724fb
[15] Deshpande, V., Oliva, E. and Young, R.H. (2010) Solid pseudopapillary neoplasm of the ovary: A report of 3 primary ovarian tumors resembling those of the pancreas. The American Journal of Surgical Pathology, 34, 1514-1520. http://dx.doi.org/10.1097/PAS.0b013e3181f133e9
[16] Geers, C., Moulin, P., Gigot, J.F., et al. (2006) Solid and pseudopapillary tumor of the pancreas—Review and new insights into pathogenesis. The American Journal of Surgical Pathology, 30, 1243-1249.
http://dx.doi.org/10.1097/01.pas.0000213311.28682.b2
[17] Mao, C., Guvendi, M., Domenico, D.R., et al. (1995) Papillary cystic and solid tumors of the pancreas: A pancreatic embryonic tumor? Studies of three cases and cumulative review of the world’s literature. Surgery, 118, 821-828. http://dx.doi.org/10.1016/S0039-6060(05)80271-5
[18] Choi, J.Y., Kim, M.J., Kim, J.H., et al. (2006) Solid pseudopapillary tumor of the pancreas: Typical and atypical manifestations. AJR, 187, 178-186.
http://dx.doi.org/10.2214/AJR.05.0569
[19] Raffel, A., Cupisti, K., Krausch, M., et al. (2004) Therapeutic strategy of papillary cystic and sold neoplasm (PCSN): A rare non-endocrine tumor of the pancreas in children. Surgical Oncology, 13, 1-6.
http://dx.doi.org/10.1016/j.suronc.2003.09.003
[20] Bostanoglu, S., Otan, E., Akturan, S., et al. (2009) Frantz’s tumor (solid-pseudopapillary tumor) of the pancreas. A case report. JOP, 10, 209-211.
[21] Kamat, R.N., Naik, L.D., Joshi, R.M., et al. (2008) Solid pseudopapillary tumor of the pancreas. Indian Journal of Pathology and Microbiology, 51, 271-273.
http://dx.doi.org/10.4103/0377-4929.41692
[22] Sperti, C., Berselli, M., Pasquali, C., et al. (2008) Aggressive behaviour of solid-pseudopapillary tumor of the pancreas in adults: A case report and review of the literature. World Journal of Gastroenterology, 14, 960-965.
http://dx.doi.org/10.3748/wjg.14.960
[23] Vergauwen, W., Op de Beeck, B., Hagendorens, M., et al. (2010) A solid pseudopapillary tumor of the pancreas presenting after an abdominal trauma. Acta Chirurgica Belgica, 110, 390-393.
[24] Hansson, B., Hubens, G., Hagendorens, M., et al. (1999) Frantz’s tumor of the pancreas presenting as a post-traumatic pancreatic pseudocyst. Acta Chirurgica Belgica, 99, 82-84.
[25] Frago, R., Fabregat, J., Jorba, R., et al. (2006) Solid pseudopapillary tumors of the pancreas: Diagnosis and curative treatment. Revista Espanola de Enfermedades Digestivas, 98, 809-816.
http://dx.doi.org/10.4321/S1130-01082006001100002
[26] Zuriarrain, A., Nir, I., Bocklage, T., et al. (2011) Pseudopapillary tumor of the pancreas in a 17-year-old girl. Journal of Clinical Oncology, 29, 395-396.
http://dx.doi.org/10.1200/JCO.2010.33.5364
[27] Chang, H., Gong, Y.I., Xu, J., et al. (2010) Clinical strategy for the management of solid pseudopapillary tumor of the pancreas. Aggressive or less? International Journal of Medical Sciences, 7, 309-613.
http://dx.doi.org/10.7150/ijms.7.309
[28] Yong, F., Fu, D.L., Jin, C., et al. (2008) Clinical experiences of solid pseudopapillary tumors of the pancreas in China. Journal of Gastroenterology and Hepatology, 23, 1847-1851. http://dx.doi.org/10.1111/j.1440-1746.2008.05526.x
[29] Salvia, R., Bassi, C., Festa, L., et al. (2007) Clinical and biological behavior of pancreatic solid-pseudopapillary tumors: Report on 31 consecutive patients. Journal of Surgical Oncology, 95, 304-310.
http://dx.doi.org/10.1002/jso.20685
[30] Goleman, K.M., Doherty, M.C. and Bigler, S.A. (2003) Solid-pseudopapillary tumor of the pancreas. Radiographics, 23, 1644-1648.
http://dx.doi.org/10.1148/rg.236035006
[31] Patil, T.B., Shrikhande, S.V., Kanhere, H.A., et al. (2006) Solid pseudopapillary neoplasm of the pancreas: A single institution experience of 14 cases. HPB, 8, 148-150.
http://dx.doi.org/10.1080/13651820510035721
[32] Yu, C.C., Tseng, J.H., Yeh, C.N., et al. (2007) Clinicopathological study of solid and pseudopapillary tumor of the pancreas: Emphasis on magnetic resonance imaging findings. World Journal of Gastroenterology, 13, 1811-1815.
[33] Dong, D.J. and Zhang, S.Z. (2006) Solid-pseudopapillary tumor of the pancreas: CT and MRI features of 3 cases. Hepatobiliary & Pancreatic Diseases International, 5, 300-304.
[34] Lee, J.H., Yu, J.S., Kim, H., et al. (2008) Solid pseudopapillary carcinoma of the pancreas: Differentiation from benign solid pseudopapillary tumour using CT and MRI. Clinical Radiology, 63, 1006-1014.
http://dx.doi.org/10.1016/j.crad.2008.04.007
[35] Huang, H.L., Shih, S.C., Chang, W.H., Chen, M.J., Chan, Y.J., et al. (2005) Solid-pseudopapillary tumor of the pancreas: Clinical experience and literature review. World Journal of Gastroenterology, 11, 1403-1409.
[36] Machado, M.C., Machado, M.A., Bacchella, T., et al. (2008) Solid pseudopapillary neoplasm of the pancreas: Distinct patterns of onset, diagnosis, and prognosis for male versus female patients. Surgery, 143, 29-34.
http://dx.doi.org/10.1016/j.surg.2007.07.030
[37] Kosuke, M., Masahiko, H., Shinya, A., et al. (2010) Small solid pseudopapillary tumor of the pancreas in a 32-year-old man: Report of a case. Surgery Today, 40, 772-776. http://dx.doi.org/10.1007/s00595-009-4139-x
[38] Santini, D., Poli, F. and Lega, S. (2006) Solid-papillary tumors of the pancreas: Histopathology. Journal of the Pancreas, 7, 131-136.
[39] Crawford Jr., B.E. (1998) Solid and papillary epithelial neoplasm of the pancreas, diagnosis by cytology. Southern Medical Journal, 91, 973-977.
http://dx.doi.org/10.1097/00007611-199810000-00017
[40] Trivedi, N., Sharma, U., Das, P.M., et al. (1999) FNAC of papillary and solid epithelial neoplasm of pancreas—A case report. Indian Journal of Pathology & Microbiology, 42, 369-372.
[41] Naresh, K.N., Borges, A.M., Chinoy, R.F., et al. (1995) Solid and papillary epithelial neoplasm of the pancreas. Diagnosis by fine needle aspiration cytology in four cases. Acta Cytologica, 39, 489-493.
[42] Burford, H., Baloch, Z., Liu, X., Jhala, D., et al. (2009) A limited immunohistochemical panel to distinguish pancreatic endocrine neoplasm from solid pseudopapillary neoplasm of the pancreas on endoscopic ultrasoundguided fine-needle aspirates of the pancreas. American Journal of Clinical Pathology, 132, 831-839.
http://dx.doi.org/10.1309/AJCPVT8FCLFDTZWI
[43] Pezzi, C.M., Schuerch, C., Erlandson, R.A., et al. (1988) Papillary-cystic neoplasm of the pancreas. Journal of Surgical Oncology, 37, 278-285.
http://dx.doi.org/10.1002/jso.2930370414
[44] Salla, C., Chatzipantelis, P., konstantinou, P., et al. (2007) Endoscopic ultrasound-guides fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: A case report and literature review. World Journal of Gastroenterology, 13, 5158-5163.
[45] Klimstra, D.S., Wenig, B.M. and Heffess, C.S. (2000) Solid-pseudopapilary tumor of the pancreas: A typically cystic carcinoma of low malignant potential. Seminars in Diagnostic Pathology, 17, 66-80.
[46] Jai, H.G. (2008). A spindle cell predominant pancreatic solid-pseudopapillary tumor. Yonsei Medical Journal, 49, 672-675. http://dx.doi.org/10.3349/ymj.2008.49.4.672
[47] Kim, M.J., Jang, S.J. and Yu, E. (2008) Loss of E-cadherin and cytoplasmic-nuclear expression of beta-catenin are the most useful immunoprofiles in the diagnosis of solid-pseudopapillary neoplasm of the pancreas. Human Pathology, 39, 251-258.
http://dx.doi.org/10.1016/j.humpath.2007.06.014
[48] Tiemann, K., Kosmahl, M., Ohlendorf, J., et al. (2006) Solid pseudopapillary neoplasms of the pancreas are associated with FLI-1 expression, but not with EWS/FLI-1 translocation. Modern Pathology, 19, 1409-1413.
[49] Tanaka, Y., Kato, K., Notohara, K., et al. (2001) Frequent β-catenin Mutation and cytoplasmic/nuclear accumulation in pancreatic solid-pseudopapillary neoplasm. Cancer Research, 61, 8401-8404.
[50] Tipton, S.G., Smyrk, T.C., Sarr, M.G., et al. (2006) Malignant potential of solid pseudopapillary neoplasm of the pancreas. British Journal of Surgery, 93, 733-737.
http://dx.doi.org/10.1002/bjs.5334
[51] Yoon, D.Y., Hines, O.J., Bilchik, A.J., et al. (2001) Solid and papillary epithelial neoplasm of the pancreas: Aggressive resection for cure. The American Journal of Surgery, 67, 1195-1199.
[52] Nakagohri, T., Kinoshita, T., Konishi, M., et al. (2008) Surgical outcome of solid pseudopapillary tumor of the pancreas. Journal of Hepato-Biliary-Pancreatic Surgery, 15, 318-321.
http://dx.doi.org/10.1007/s00534-007-1264-z
[53] Siquini, W., Marmorale, C., Guercioni, G., et al. (2006) Solid pseudopapillary tumor of the pancreas. A report of 3 cases and e review of the literature. Chirurgia Italiana, 58, 235-245.
[54] Yang, F., Jin, C., Long, J., et al. (2009) Solid pseudopapillary tumor of the pancreas: A case series of 26 consecutive patients. The American Journal of Surgery, 198, 210-215.
http://dx.doi.org/10.1016/j.amjsurg.2008.07.062
[55] Nagri, S., Abdu, A., Ananad, S., et al. (2007) Liver metastasis four years after Whipple’s resection for solidpseudopapillary tumor of the pancreas. Journal of Pancreas, 8, 223-227.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.